S99.091B ICD-10-CM Code: Other physeal fracture of right calcaneus, 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 913 — TRAUMATIC INJURY WITH MCC (MDC 21)
- MS-DRG 914 — TRAUMATIC INJURY WITHOUT MCC (MDC 21)
- 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.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S99.091B in the official ICD-10-CM tabular list.
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 S99.091B vs T20 →
- fracture of ankle and malleolus (S82.-) Compare S99.091B vs S82 →
- frostbite (T33-T34) Compare S99.091B vs T33 →
- insect bite or sting, venomous (T63.4) Compare S99.091B vs T63.4 →
Change history
- FY2017 — 2016-10-01Added to the code setOther physeal fracture of right calcaneus, initial encounter for open fractureFY2017 changes
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.
Contextual Map
Every relationship of S99.091B 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]
- S90-S99 — Injuries to the ankle and foot [Hierarchy]
Referenced by Excludes2 notes
- S89 — Other and unspecified injuries of lower leg [Excludes2](via S99.-): “other and unspecified injuries of ankle and foot (S99.-)” · check together
- S92.0 — Fracture of calcaneus [Excludes2](via S99.0.-): “Physeal fracture of calcaneus (S99.0-)” · check together
Clinical classification (CCSR)
- INJ005 — Fracture of the lower limb (except hip), initial encounter [CCSR]
Potential MS-DRG
- DRG 913 — TRAUMATIC INJURY WITH MCC [MS-DRG]: “TRAUMATIC INJURY WITH MCC (MDC 21)”
- DRG 914 — TRAUMATIC INJURY WITHOUT MCC [MS-DRG]: “TRAUMATIC INJURY WITHOUT MCC (MDC 21)”
- DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
- DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
- DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”
MDC crossing · procedures (54986)
- MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs [MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — 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 24 — Multiple Significant Trauma [MDC crossing]: “Multiple Significant Trauma — 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.”
- 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- and 54981 more
Nearest codes (40)
- S99 — Other and unspecified injuries of ankle and foot [Sibling]
- S99.041S — Salter-Harris Type IV physeal fracture of right calcaneus, sequela [Sibling]
- S99.042 — Salter-Harris Type IV physeal fracture of left calcaneus [Sibling]
- S99.042A — Salter-Harris Type IV physeal fracture of left calcaneus, initial encounter for closed fracture [Sibling]
- S99.042B — Salter-Harris Type IV physeal fracture of left calcaneus, initial encounter for open fracture [Sibling]
- S99.042D — Salter-Harris Type IV physeal fracture of left calcaneus, subsequent encounter for fracture with routine healing [Sibling]
- S99.042G — Salter-Harris Type IV physeal fracture of left calcaneus, subsequent encounter for fracture with delayed healing [Sibling]
- S99.042K — Salter-Harris Type IV physeal fracture of left calcaneus, subsequent encounter for fracture with nonunion [Sibling]
- and 32 more
Change history
- FY2017 — Added to the code set [Change history]
Referenced by Other Codes
Clinical classification (AHRQ CCSR):INJ005 — Fracture of the lower limb (except hip), 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)
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 5 MS-DRGs: DRG 913 (MDC 21), DRG 914 (MDC 21), 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 S99.091B or its code family.
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S99.091B require a 7th character?
Yes. The appropriate 7th character is to be added to each code from subcategories S99.0.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S99.091B in its code family, with their registry titles.
- S99.049P — Salter-Harris Type IV physeal fracture of unspecified calcaneus, subsequent encounter for fracture with malunion
- S99.049S — Salter-Harris Type IV physeal fracture of unspecified calcaneus, sequela
- S99.09 — Other physeal fracture of calcaneus
- S99.091 — Other physeal fracture of right calcaneus
- S99.091A — Other physeal fracture of right calcaneus, initial encounter for closed fracture
- S99.091D — Other physeal fracture of right calcaneus, subsequent encounter for fracture with routine healing
- S99.091G — Other physeal fracture of right calcaneus, subsequent encounter for fracture with delayed healing
- S99.091K — Other physeal fracture of right calcaneus, subsequent encounter for fracture with nonunion
- S99.091P — Other physeal fracture of right calcaneus, subsequent encounter for fracture with malunion
- S99.091S — Other physeal fracture of right calcaneus, sequela