Excludes1 pair
S82- vs S82.5-
S82 and S82.5 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on S82.5
pilon fracture of distal tibia (S82.87-)
S82
Fracture of lower leg, including ankle
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S80-S89
Use when the record says
- fracture of malleolus
S82.5
Fracture of medial malleolus
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S80-S89
Indexed under
- Fracture, traumatic › ankle › medial malleolus (displaced)
- Fracture, traumatic › ankle › medial malleolus › nondisplaced
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027