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S99.201K ICD-10-CM Code: Unspecified physeal fracture of phalanx of right toe, subsequent encounter for fracture with nonunion

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.

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 phalanx of right toe, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S99.201K).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S99.201K 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.

Frequently Compared Codes

The official Excludes notes on S99.201K name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Unspecified physeal fracture of phalanx of right toe, subsequent encounter for fracture with nonunion
    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 S99.201K 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
  • S92.4 — Fracture of great toe [Excludes2](via S99.2.-): “Physeal fracture of phalanx of toe (S99.2-)” · check together
  • S92.5 — Fracture of lesser toe(s) [Excludes2](via S99.2.-): “Physeal fracture of phalanx of toe (S99.2-)” · check together

Clinical classification (CCSR)

  • INJ042 — Fracture of lower limb (except hip), subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 949 — AFTERCARE WITH CC/MCC [MS-DRG]: “AFTERCARE WITH CC/MCC (MDC 23)”
  • DRG 950 — AFTERCARE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE WITHOUT CC/MCC (MDC 23)”

MDC crossing · procedures (1235)

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services [MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — 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.”
  • F003GKZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GMZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GPZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GYZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GZZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • and 1230 more

Nearest codes (40)

  • S99 — Other and unspecified injuries of ankle and foot [Sibling]
  • S99.192D — Other physeal fracture of left metatarsal, subsequent encounter for fracture with routine healing [Sibling]
  • S99.192G — Other physeal fracture of left metatarsal, subsequent encounter for fracture with delayed healing [Sibling]
  • S99.192K — Other physeal fracture of left metatarsal, subsequent encounter for fracture with nonunion [Sibling]
  • S99.192P — Other physeal fracture of left metatarsal, subsequent encounter for fracture with malunion [Sibling]
  • S99.192S — Other physeal fracture of left metatarsal, sequela [Sibling]
  • S99.199 — Other physeal fracture of unspecified metatarsal [Sibling]
  • S99.199A — Other physeal fracture of unspecified metatarsal, initial encounter for closed fracture [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

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.

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 2 MS-DRGs: DRG 949 (MDC 23), DRG 950 (MDC 23).

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 S99.201K or its code family.

3 Excludes2 notes: S89 (via S99.-), S92.4 (via S99.2.-), S92.5 (via S99.2.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S99.201K require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategories S99.2.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S99.201K in its code family, with their registry titles.

  • S99.201 — Unspecified physeal fracture of phalanx of right toe
  • S99.201A — Unspecified physeal fracture of phalanx of right toe, initial encounter for closed fracture
  • S99.201B — Unspecified physeal fracture of phalanx of right toe, initial encounter for open fracture
  • S99.201D — Unspecified physeal fracture of phalanx of right toe, subsequent encounter for fracture with routine healing
  • S99.201G — Unspecified physeal fracture of phalanx of right toe, subsequent encounter for fracture with delayed healing
  • S99.201P — Unspecified physeal fracture of phalanx of right toe, subsequent encounter for fracture with malunion
  • S99.201S — Unspecified physeal fracture of phalanx of right toe, sequela
  • S99.202 — Unspecified physeal fracture of phalanx of left toe
  • S99.202A — Unspecified physeal fracture of phalanx of left toe, initial encounter for closed fracture
  • S99.202B — Unspecified physeal fracture of phalanx of left toe, initial encounter for open fracture

View all codes in the S99 family