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ICD-10/S02.80XA

S02.80XA ICD-10-CM Code: Fracture of other specified skull and facial bones, unspecified side, initial encounter for closed fracture

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • MS-DRG 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)
  • MS-DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)
  • MS-DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC (MDC 08)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 399 — Major Head Injury without Loss of Consciousness

Other models: CMS-HCC V22 HCC 167

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Fracture of other specified skull and facial bones, unspecified side, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S02.80A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S02.80XA in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated intracranial injury (S06.-)
  • for any associated infection

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Fracture of other specified skull and facial bones, unspecified side, initial encounter for closed fracture
    FY2017 changes

Verify Before Coding

  • Billable — reportable as written.
  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of S02.80XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S00-S09 — Injuries to the head [Hierarchy]

Referenced by Excludes1 notes

  • S01 — Open wound of head [Excludes1](via S02.-): “open skull fracture (S02.- with 7th character B)” · check together

Referenced by Excludes2 notes

  • S05 — Injury of eye and orbit [Excludes2](via S02.8.-): “orbital bone fracture (S02.1-, S02.3-, S02.8-)” · check together

Referenced by Code First instructions

Referenced by Use Additional Code instructions

  • S07 — Crushing injury of head [Use Additional Code](via S02.-): “skull fractures (S02.-)” · check together

Referenced by Code Also instructions

  • S04 — Injury of cranial nerve [Code Also](via S02.-): “skull fracture (S02.-)” · check together
  • S06 — Intracranial injury [Code Also](via S02.-): “skull fracture (S02.-)” · check together

Clinical classification (CCSR)

  • INJ001 — Fracture of head and neck, initial encounter [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 399 — Major Head Injury without Loss of Consciousness [CMS-HCC]

Potential MS-DRG (9)

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)”
  • DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)”
  • DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)”
  • DRG 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)”
  • DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)”
  • DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC (MDC 08)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • and 2 more

MDC crossing · procedures (41618)

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 02HA0QZ — Insertion of Implantable Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA0RZ — Insertion of Short-term External Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Short-term External Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA3QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA4QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02RA0LZ — Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach [Same-MDC procedure]: “Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • and 41613 more

Nearest codes (40)

  • S02 — Fracture of skull and facial bones [Sibling]
  • S02.671D — Fracture of alveolus of right mandible, subsequent encounter for fracture with routine healing [Sibling]
  • S02.671G — Fracture of alveolus of right mandible, subsequent encounter for fracture with delayed healing [Sibling]
  • S02.671K — Fracture of alveolus of right mandible, subsequent encounter for fracture with nonunion [Sibling]
  • S02.671S — Fracture of alveolus of right mandible, sequela [Sibling]
  • S02.672 — Fracture of alveolus of left mandible [Sibling]
  • S02.672A — Fracture of alveolus of left mandible, initial encounter for closed fracture [Sibling]
  • S02.672B — Fracture of alveolus of left mandible, initial encounter for open fracture [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):INJ001 — Fracture of head and neck, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 413 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 9 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 564 (MDC 08), DRG 565 (MDC 08), DRG 566 (MDC 08), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name S02.80XA or its code family.

1 Excludes1 notes: S01 (via S02.-).

1 Excludes2 notes: S05 (via S02.8.-).

1 Code First instructions: R40.2 (via S02.-).

1 Use Additional Code instructions: S07 (via S02.-).

2 Code Also instructions: S04 (via S02.-), S06 (via S02.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S02.80XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S02.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S02.80XA in its code family, with their registry titles.

  • S02.69XG — Fracture of mandible of other specified site, subsequent encounter for fracture with delayed healing
  • S02.69XK — Fracture of mandible of other specified site, subsequent encounter for fracture with nonunion
  • S02.69XS — Fracture of mandible of other specified site, sequela
  • S02.8 — Fractures of other specified skull and facial bones
  • S02.80 — Fracture of other specified skull and facial bones, unspecified side
  • S02.80XB — Fracture of other specified skull and facial bones, unspecified side, initial encounter for open fracture
  • S02.80XD — Fracture of other specified skull and facial bones, unspecified side, subsequent encounter for fracture with routine healing
  • S02.80XG — Fracture of other specified skull and facial bones, unspecified side, subsequent encounter for fracture with delayed healing
  • S02.80XK — Fracture of other specified skull and facial bones, unspecified side, subsequent encounter for fracture with nonunion
  • S02.80XS — Fracture of other specified skull and facial bones, unspecified side, sequela

View all codes in the S02 family