S02.630A — Fracture of coronoid process of mandible, unspecified side, initial encounter for closed fracture
Is S02.630A billable?
Yes, but S02.630A will trip a Medicare edit. S02.630A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S02.630A 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.
S02.630A at a glance
| Code | S02.630A |
|---|---|
| Description | Fracture of coronoid process of mandible, unspecified side, initial encounter for closed fracture |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter for closed fracture |
What does the 7th character "A" mean in S02.630A?
In S02.630A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S02.630A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S02.630A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S02.630A 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 S02.630A group to?
S02.630A sits in MDC Pre 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.
- 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
- 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
- 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical
As a secondary diagnosis, S02.630A 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 S02.630A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S02.63, the nearest indexed parent of S02.630A. Use them to find the family, then select the specific code.
- Fracture, traumatic › mandible › coronoid process (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S02.630A to fully describe the condition. S02.630A 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 S02.630A, but a patient may have both at the same time. When documentation supports it, S02.630A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S00-S09
The conditions below are not part of S02.630A, but a patient may have both at the same time. When documentation supports it, S02.630A 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)
Code also — inherited from S00-S09
Two codes may be needed to describe the condition fully. Whether S02.630A 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 S02.630A is sequenced first depends on the reason for the encounter.
- any associated intracranial injury (S06.-)
How long has S02.630A existed?
S02.630A first appears in FY2018 (FY2017 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.