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ICD-10/S99.109B

S99.109B ICD-10-CM Code: Unspecified physeal fracture of unspecified metatarsal, 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

Unspecified physeal fracture of unspecified metatarsal, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S99.109B).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S99.109B 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.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Unspecified physeal fracture of unspecified metatarsal, initial encounter for open fracture
    FY2017 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 S99.109B 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
  • S92.3 — Fracture of metatarsal bone(s) [Excludes2](via S99.1.-): “Physeal fracture of metatarsal (S99.1-)” · 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]
  • S99.1 — Physeal fracture of metatarsal [Sibling]
  • S99.10 — Unspecified physeal fracture of metatarsal [Sibling]
  • S99.101 — Unspecified physeal fracture of right metatarsal [Sibling]
  • S99.101A — Unspecified physeal fracture of right metatarsal, initial encounter for closed fracture [Sibling]
  • S99.101B — Unspecified physeal fracture of right metatarsal, initial encounter for open fracture [Sibling]
  • S99.101D — Unspecified physeal fracture of right metatarsal, subsequent encounter for fracture with routine healing [Sibling]
  • S99.101G — Unspecified physeal fracture of right metatarsal, subsequent encounter for fracture with delayed healing [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 S99.109B or its code family.

2 Excludes2 notes: S89 (via S99.-), S92.3 (via S99.1.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S99.109B require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategories S99.1.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S99.109B in its code family, with their registry titles.

  • S99.102K — Unspecified physeal fracture of left metatarsal, subsequent encounter for fracture with nonunion
  • S99.102P — Unspecified physeal fracture of left metatarsal, subsequent encounter for fracture with malunion
  • S99.102S — Unspecified physeal fracture of left metatarsal, sequela
  • S99.109 — Unspecified physeal fracture of unspecified metatarsal
  • S99.109A — Unspecified physeal fracture of unspecified metatarsal, initial encounter for closed fracture
  • S99.109D — Unspecified physeal fracture of unspecified metatarsal, subsequent encounter for fracture with routine healing
  • S99.109G — Unspecified physeal fracture of unspecified metatarsal, subsequent encounter for fracture with delayed healing
  • S99.109K — Unspecified physeal fracture of unspecified metatarsal, subsequent encounter for fracture with nonunion
  • S99.109P — Unspecified physeal fracture of unspecified metatarsal, subsequent encounter for fracture with malunion
  • S99.109S — Unspecified physeal fracture of unspecified metatarsal, sequela

View all codes in the S99 family