ICDcodes.org
FY2027

S02.112A — Type III occipital condyle fracture, unspecified side, initial encounter for closed fracture

BillableUnspecifiedCC

Is S02.112A billable?

Yes, but S02.112A will trip a Medicare edit. S02.112A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S02.112A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

S02.112A at a glance

CodeS02.112A
DescriptionType III occipital condyle fracture, unspecified side, initial encounter for closed fracture
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "A"initial encounter for closed fracture

What does the 7th character "A" mean in S02.112A?

In S02.112A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S02.112A to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to S02.112A?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S02.112A directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does S02.112A group to?

S02.112A sits in MDC 01 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 082Traumatic Stupor and Coma >1 Hour with MCCmedical
  • 083Traumatic Stupor and Coma >1 Hour with CCmedical
  • 084Traumatic Stupor and Coma >1 Hour without CC/MCCmedical

As a secondary diagnosis, S02.112A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.

How is S02.112A listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S02.112, the nearest indexed parent of S02.112A. Use them to find the family, then select the specific code.

  • Fracture, traumatic › skull › base › occiput › condyle › type III (abduction) (adduction) (separation)

Use additional code — inherited from Chapter 19

Report an additional code alongside S02.112A to fully describe the condition. S02.112A is sequenced first.

  • code to identify any retained foreign body, if applicable (Z18.-)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of S02.112A, but a patient may have both at the same time. When documentation supports it, S02.112A and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from S00-S09

The conditions below are not part of S02.112A, but a patient may have both at the same time. When documentation supports it, S02.112A and the excluded code may both be reported.

  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)
  • effects of foreign body in nose (T17.0-T17.1)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body on external eye (T15.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)

Excludes2 — not included here — inherited from S02.1

The conditions below are not part of S02.112A, but a patient may have both at the same time. When documentation supports it, S02.112A and the excluded code may both be reported.

Code also — inherited from S00-S09

Two codes may be needed to describe the condition fully. Whether S02.112A is sequenced first depends on the reason for the encounter.

  • for any associated infection

Code also — inherited from S02

Two codes may be needed to describe the condition fully. Whether S02.112A is sequenced first depends on the reason for the encounter.

  • any associated intracranial injury (S06.-)

How long has S02.112A existed?

S02.112A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Description changes
  • FY2018
    Type III occipital condyle fracture, initial encounter for closed fracture
    Type III occipital condyle fracture, unspecified side, initial encounter for closed fracture

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.