S02.129K — Fracture of orbital roof, unspecified side, subsequent encounter for fracture with nonunion
Is S02.129K billable?
Yes, but S02.129K will trip a Medicare edit. S02.129K is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S02.129K 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.
S02.129K at a glance
| Code | S02.129K |
|---|---|
| Description | Fracture of orbital roof, unspecified side, subsequent encounter for fracture with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "K" | subsequent encounter for fracture with nonunion |
What does the 7th character "K" mean in S02.129K?
In S02.129K, the 7th character K means subsequent encounter for fracture with nonunion. The 7th character is required for S02.129K to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S02.129K?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S02.129K directly.
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 S02.129K group to?
S02.129K sits in MDC 23 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 949Aftercare with CC/MCCmedical
- 950Aftercare without CC/MCCmedical
As a secondary diagnosis, S02.129K is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S02.129K listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S02.12, the nearest indexed parent of S02.129K. Use them to find the family, then select the specific code.
- Fracture, traumatic › orbit, orbital › roof (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S02.129K to fully describe the condition. S02.129K 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 S02.129K, but a patient may have both at the same time. When documentation supports it, S02.129K and the excluded code may both be reported.
Excludes2 — not included here — inherited from S00-S09
The conditions below are not part of S02.129K, but a patient may have both at the same time. When documentation supports it, S02.129K 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 S02.129K, but a patient may have both at the same time. When documentation supports it, S02.129K 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 S02.129K 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 S02.129K is sequenced first depends on the reason for the encounter.
- any associated intracranial injury (S06.-)
How long has S02.129K existed?
S02.129K first appears in FY2021 (FY2020 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.