S82.56XR ICD-10-CM Code: Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
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 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)
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.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S82.56XR in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- fracture of malleolus
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- pilon fracture of distal tibia (S82.87-) Compare S82.56XR vs S82.87 →
- Salter-Harris type III of lower end of tibia (S89.13-) Compare S82.56XR vs S89.13 →
- Salter-Harris type IV of lower end of tibia (S89.14-) Compare S82.56XR vs S89.14 →
- traumatic amputation of lower leg (S88.-) Compare S82.56XR vs S88 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- fracture of foot, except ankle (S92.-) Compare S82.56XR vs S92 →
- periprosthetic fracture around internal prosthetic ankle joint (M97.2) Compare S82.56XR vs M97.2 →
- periprosthetic fracture around internal prosthetic implant of knee joint (M97.1-) Compare S82.56XR vs M97.1 →
- burns and corrosions (T20-T32) Compare S82.56XR vs T20 →
- frostbite (T33-T34) Compare S82.56XR vs T33 →
- injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99) Compare S82.56XR vs S90 →
- insect bite or sting, venomous (T63.4) Compare S82.56XR vs T63.4 →
Frequently Compared Codes
The official Excludes notes on S82.56XR 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
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Relationships & Classification
Official ICD-10-CM tabular notes on other codes that name S82.56XR or its code family.
6 Excludes1 notes across 2 chapters: M84.3 (via S82.-), M84.4 (via S82.-), S81 (via S82.-), S82.3 (via S82.5.-), S89.13 (via S82.5.-), S89.14 (via S82.5.-).
12 Excludes2 notes: S72 (via S82.-), S90 (via S82.-), S90-S99 (via S82.-), S91 (via S82.-), S92 (via S82.-), S93 (via S82.-), S94 (via S82.-), S95 (via S82.-), S96 (via S82.-), S97 (via S82.-) and 2 more.
Potential MS-DRG Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 3 MS-DRGs: DRG 564 (MDC 08), DRG 565 (MDC 08), DRG 566 (MDC 08).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):INJ042 — Fracture of lower limb (except hip), subsequent encounter (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Contextual Map
Every relationship of S82.56XR 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]
- S80-S89 — Injuries to the knee and lower leg [Hierarchy]
Referenced by Excludes1 notes
- M84.3 — Stress fracture [Excludes1](via S82.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
- M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via S82.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
- S81 — Open wound of knee and lower leg [Excludes1](via S82.-): “open fracture of knee and lower leg (S82.-)” · check together
- S82.3 — Fracture of lower end of tibia [Excludes1](via S82.5.-): “fracture of medial malleolus alone (S82.5-)” · check together
- S89.13 — Salter-Harris Type III physeal fracture of lower end of tibia [Excludes1](via S82.5.-): “fracture of medial malleolus (adult) (S82.5-)” · check together
- S89.14 — Salter-Harris Type IV physeal fracture of lower end of tibia [Excludes1](via S82.5.-): “fracture of medial malleolus (adult) (S82.5-)” · check together
Referenced by Excludes2 notes (12)
- S72 — Fracture of femur [Excludes2](via S82.-): “fracture of lower leg and ankle (S82.-)” · check together
- S90 — Superficial injury of ankle, foot and toes [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- S90-S99 — Injuries to the ankle and foot (S90-S99) [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- S91 — Open wound of ankle, foot and toes [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- S92 — Fracture of foot and toe, except ankle [Excludes2](via S82.-): “fracture of ankle (S82.-)” · check together
- S93 — Dislocation and sprain of joints and ligaments at ankle, foot and toe level [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- S94 — Injury of nerves at ankle and foot level [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- S95 — Injury of blood vessels at ankle and foot level [Excludes2](via S82.-): “fracture of ankle and malleolus (S82.-)” · check together
- and 4 more
Clinical classification (CCSR)
- INJ042 — Fracture of lower limb (except hip), subsequent encounter [CCSR]
Potential MS-DRG
- 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)”
MDC crossing · procedures (18508)
- 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.”
- 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
- 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
- 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
- 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
- 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
- and 18503 more
Nearest codes (40)
- S82 — Fracture of lower leg, including ankle [Sibling]
- S82.55XN — Nondisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion [Sibling]
- S82.55XP — Nondisplaced fracture of medial malleolus of left tibia, subsequent encounter for closed fracture with malunion [Sibling]
- S82.55XQ — Nondisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type I or II with malunion [Sibling]
- S82.55XR — Nondisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion [Sibling]
- S82.55XS — Nondisplaced fracture of medial malleolus of left tibia, sequela [Sibling]
- S82.56 — Nondisplaced fracture of medial malleolus of unspecified tibia [Sibling]
- S82.56XA — Nondisplaced fracture of medial malleolus of unspecified tibia, initial encounter for closed fracture [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S82.56XR require a 7th character?
Yes. The appropriate 7th character is to be added to all codes from category S82.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S82.56XR in its code family, with their registry titles.
- S82.56XK — Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for closed fracture with nonunion
- S82.56XM — Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type I or II with nonunion
- S82.56XN — Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S82.56XP — Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for closed fracture with malunion
- S82.56XQ — Nondisplaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type I or II with malunion
- S82.56XS — Nondisplaced fracture of medial malleolus of unspecified tibia, sequela
- S82.6 — Fracture of lateral malleolus
- S82.61 — Displaced fracture of lateral malleolus of right fibula
- S82.61XA — Displaced fracture of lateral malleolus of right fibula, initial encounter for closed fracture
- S82.61XB — Displaced fracture of lateral malleolus of right fibula, initial encounter for open fracture type I or II