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ICD-10/S02.842A

S02.842A ICD-10-CM Code: Fracture of lateral orbital wall, left 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 082 — TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC (MDC 01)
  • MS-DRG 083 — TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC (MDC 01)
  • MS-DRG 084 — TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC (MDC 01)
  • MS-DRG 085 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC (MDC 01)
  • MS-DRG 086 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC (MDC 01)
  • MS-DRG 087 — TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC (MDC 01)
  • 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 lateral orbital wall, left side, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S02.842A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S02.842A 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

  • FY2020 — 2019-10-01
    Added to the code set
    Fracture of lateral orbital wall, left side, initial encounter for closed fracture
    FY2020 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 S02.842A 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

  • S02.842 — Fracture of lateral orbital wall, left side [Hierarchy]

Referenced by Excludes1 notes

  • S01 — Open wound of head [Excludes1](via S02.-): “open skull fracture (S02.- with 7th character B)”
  • S02.85 — Fracture of orbit, unspecified [Excludes1](via S02.84.-): “lateral orbital wall (S02.84-)”

Referenced by Excludes2 notes

  • S02.1 — Fracture of base of skull [Excludes2](via S02.84.-): “lateral orbital wall (S02.84-)”
  • S02.3 — Fracture of orbital floor [Excludes2](via S02.84.-): “lateral orbital wall (S02.84-)”
  • S05 — Injury of eye and orbit [Excludes2](via S02.8.-): “orbital bone fracture (S02.1-, S02.3-, S02.8-)”

Referenced by Code First instructions

  • R40.2 — Coma [Code First](via S02.-): “fracture of skull (S02.-)”

Referenced by Use Additional Code instructions

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

Referenced by Code Also instructions

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

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 (12)

  • 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 082 — TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC [MS-DRG]: “TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC (MDC 01)”
  • DRG 083 — TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC [MS-DRG]: “TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC (MDC 01)”
  • DRG 084 — TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC [MS-DRG]: “TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC (MDC 01)”
  • DRG 085 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC [MS-DRG]: “TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC (MDC 01)”
  • and 5 more

Nearest codes (40)

  • S02 — Fracture of skull and facial bones [Sibling]
  • S02.832D — Fracture of medial orbital wall, left side, subsequent encounter for fracture with routine healing [Sibling]
  • S02.832G — Fracture of medial orbital wall, left side, subsequent encounter for fracture with delayed healing [Sibling]
  • S02.832K — Fracture of medial orbital wall, left side, subsequent encounter for fracture with nonunion [Sibling]
  • S02.832S — Fracture of medial orbital wall, left side, sequela [Sibling]
  • S02.839 — Fracture of medial orbital wall, unspecified side [Sibling]
  • S02.839A — Fracture of medial orbital wall, unspecified side, initial encounter for closed fracture [Sibling]
  • S02.839B — Fracture of medial orbital wall, unspecified side, initial encounter for open fracture [Sibling]
  • and 32 more

Change history

  • FY2020 — 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 12 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 082 (MDC 01), DRG 083 (MDC 01), DRG 084 (MDC 01), DRG 085 (MDC 01), DRG 086 (MDC 01), DRG 087 (MDC 01), DRG 963 (MDC 24) and 2 more.

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 S02.842A or its code family.

2 Excludes1 notes: S01 (via S02.-), S02.85 (via S02.84.-).

3 Excludes2 notes: S02.1 (via S02.84.-), S02.3 (via S02.84.-), 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 S02.842A 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 S02.842A in its code family, with their registry titles.

  • S02.841D — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with routine healing
  • S02.841G — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with delayed healing
  • S02.841K — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with nonunion
  • S02.841S — Fracture of lateral orbital wall, right side, sequela
  • S02.842 — Fracture of lateral orbital wall, left side
  • S02.842B — Fracture of lateral orbital wall, left side, initial encounter for open fracture
  • S02.842D — Fracture of lateral orbital wall, left side, subsequent encounter for fracture with routine healing
  • S02.842G — Fracture of lateral orbital wall, left side, subsequent encounter for fracture with delayed healing
  • S02.842K — Fracture of lateral orbital wall, left side, subsequent encounter for fracture with nonunion
  • S02.842S — Fracture of lateral orbital wall, left side, sequela

View all codes in the S02 family