S02.92XB ICD-10-CM Code: Unspecified fracture of facial bones, initial encounter for open 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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S02.92XB 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.
- burns and corrosions (T20-T32) Compare S02.92XB vs T20 →
- effects of foreign body in ear (T16) Compare S02.92XB vs T16 →
- effects of foreign body in larynx (T17.3) Compare S02.92XB vs T17.3 →
- effects of foreign body in mouth NOS (T18.0) Compare S02.92XB vs T18.0 →
- effects of foreign body in nose (T17.0-T17.1) Compare S02.92XB vs T17.0 →
- effects of foreign body in pharynx (T17.2) Compare S02.92XB vs T17.2 →
- effects of foreign body on external eye (T15.-) Compare S02.92XB vs T15 →
- frostbite (T33-T34) Compare S02.92XB vs T33 →
- insect bite or sting, venomous (T63.4) Compare S02.92XB vs T63.4 →
Code Also
Additional codes that may be required to fully describe the encounter.
- any associated intracranial injury (S06.-)
- for any associated infection
Frequently Compared Codes
The official Excludes notes on S02.92XB name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- 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.
Relationships & Classification
Other codes that name S02.92XB or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
1 Excludes1 notes: S01 (via S02.-).
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.-).
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.
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.
Related Codes
Same injury, other encounter phase
Same injury, coded at a different phase of treatment via the 7th character.
S02.92XA — Unspecified fracture of facial bones, initial encounter for closed fracture Compare S02.92XB vs S02.92XA →, S02.92XD — Unspecified fracture of facial bones, subsequent encounter for fracture with routine healing, S02.92XG — Unspecified fracture of facial bones, subsequent encounter for fracture with delayed healing, S02.92XK — Unspecified fracture of facial bones, subsequent encounter for fracture with nonunion, S02.92XS — Unspecified fracture of facial bones, sequela
Same CMS-HCC risk category (V28)
CMS maps these diagnoses to the same Hierarchical Condition Category (Major Head Injury without Loss of Consciousness) for risk-adjusted payment.
S02.841B — Fracture of lateral orbital wall, right side, initial encounter for open fracture, S02.842A — Fracture of lateral orbital wall, left side, initial encounter for closed fracture, S02.842B — Fracture of lateral orbital wall, left side, initial encounter for open fracture, S02.849A — Fracture of lateral orbital wall, unspecified side, initial encounter for closed fracture, S02.849B — Fracture of lateral orbital wall, unspecified side, initial encounter for open fracture, S02.85XA — Fracture of orbit, unspecified, initial encounter for closed fracture, S02.85XB — Fracture of orbit, unspecified, initial encounter for open fracture, S02.91XA — Unspecified fracture of skull, initial encounter for closed fracture, S02.91XB — Unspecified fracture of skull, initial encounter for open fracture, S02.92XA — Unspecified fracture of facial bones, initial encounter for closed fracture, S06.1X0A — Traumatic cerebral edema without loss of consciousness, initial encounter, S06.1XAA — Traumatic cerebral edema with loss of consciousness status unknown, initial encounter, S06.2X0A — Diffuse traumatic brain injury without loss of consciousness, initial encounter, S06.2XAA — Diffuse traumatic brain injury with loss of consciousness status unknown, initial encounter, S06.300A — Unspecified focal traumatic brain injury without loss of consciousness, initial encounter, S06.30AA — Unspecified focal traumatic brain injury with loss of consciousness status unknown, initial encounter, S06.310A — Contusion and laceration of right cerebrum without loss of consciousness, initial encounter, S06.31AA — Contusion and laceration of right cerebrum with loss of consciousness status unknown, initial encounter, S06.320A — Contusion and laceration of left cerebrum without loss of consciousness, initial encounter, S06.32AA — Contusion and laceration of left cerebrum with loss of consciousness status unknown, initial encounter, +168 more
Related risk categories
These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.
Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified, Major Head Injury with Loss of Consciousness > 1 Hour
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Fracture of head and neck, initial encounter).
S02.81XB — Fracture of other specified skull and facial bones, right side, initial encounter for open fracture, S02.82XA — Fracture of other specified skull and facial bones, left side, initial encounter for closed fracture, S02.82XB — Fracture of other specified skull and facial bones, left side, initial encounter for open fracture, S02.831A — Fracture of medial orbital wall, right side, initial encounter for closed fracture, S02.831B — Fracture of medial orbital wall, right side, initial encounter for open fracture, S02.832A — Fracture of medial orbital wall, left side, initial encounter for closed fracture, S02.832B — Fracture of medial orbital wall, left side, initial encounter for open fracture, S02.839A — Fracture of medial orbital wall, unspecified side, initial encounter for closed fracture, S02.839B — Fracture of medial orbital wall, unspecified side, initial encounter for open fracture, S02.841A — Fracture of lateral orbital wall, right side, initial encounter for closed fracture, S02.841B — Fracture of lateral orbital wall, right side, initial encounter for open fracture, S02.842A — Fracture of lateral orbital wall, left side, initial encounter for closed fracture, S02.842B — Fracture of lateral orbital wall, left side, initial encounter for open fracture, S02.849A — Fracture of lateral orbital wall, unspecified side, initial encounter for closed fracture, S02.849B — Fracture of lateral orbital wall, unspecified side, initial encounter for open fracture, S02.85XA — Fracture of orbit, unspecified, initial encounter for closed fracture, S02.85XB — Fracture of orbit, unspecified, initial encounter for open fracture, S02.91XA — Unspecified fracture of skull, initial encounter for closed fracture, S02.91XB — Unspecified fracture of skull, initial encounter for open fracture, S02.92XA — Unspecified fracture of facial bones, initial encounter for closed fracture, +131 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)
Contextual Map
Every relationship of S02.92XB 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 Code First instructions
- R40.2 — Coma [Code First](via S02.-): “fracture of skull (S02.-)” · check together
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]
- S02.841B — Fracture of lateral orbital wall, right side, initial encounter for open fracture [Sibling]
- S02.841D — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with routine healing [Sibling]
- S02.841G — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with delayed healing [Sibling]
- S02.841K — Fracture of lateral orbital wall, right side, subsequent encounter for fracture with nonunion [Sibling]
- S02.841S — Fracture of lateral orbital wall, right side, sequela [Sibling]
- S02.842 — Fracture of lateral orbital wall, left side [Sibling]
- S02.842A — Fracture of lateral orbital wall, left side, initial encounter for closed fracture [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S02.92XB 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 S02.92XB in its code family, with their registry titles.
- S02.91XB — Unspecified fracture of skull, initial encounter for open fracture
- S02.91XD — Unspecified fracture of skull, subsequent encounter for fracture with routine healing
- S02.91XG — Unspecified fracture of skull, subsequent encounter for fracture with delayed healing
- S02.91XK — Unspecified fracture of skull, subsequent encounter for fracture with nonunion
- S02.91XS — Unspecified fracture of skull, sequela
- S02.92 — Unspecified fracture of facial bones
- S02.92XA — Unspecified fracture of facial bones, initial encounter for closed fracture
- S02.92XD — Unspecified fracture of facial bones, subsequent encounter for fracture with routine healing
- S02.92XG — Unspecified fracture of facial bones, subsequent encounter for fracture with delayed healing
- S02.92XK — Unspecified fracture of facial bones, subsequent encounter for fracture with nonunion