S82.036B — Nondisplaced transverse fracture of unspecified patella, initial encounter for open fracture type I or II
Is S82.036B billable?
Yes, but S82.036B will trip a Medicare edit. S82.036B is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S82.036B 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.
More specific alternatives
- S82.031BDisplaced transverse fracture of right patella, initial encounter for open fracture type I or II
- S82.032BDisplaced transverse fracture of left patella, initial encounter for open fracture type I or II
- S82.034BNondisplaced transverse fracture of right patella, initial encounter for open fracture type I or II
- S82.035BNondisplaced transverse fracture of left patella, initial encounter for open fracture type I or II
S82.036B at a glance
| Code | S82.036B |
|---|---|
| Description | Nondisplaced transverse fracture of unspecified patella, initial encounter for open fracture type I or II |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "B" | initial encounter for open fracture type I or II |
What does the 7th character "B" mean in S82.036B?
In S82.036B, the 7th character B means initial encounter for open fracture type I or II. The 7th character is required for S82.036B to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS82.036A
- Binitial encounter for open fracture type I or IIS82.036B
- Cinitial encounter for open fracture type IIIA, IIIB, or IIICS82.036C
- Dsubsequent encounter for closed fracture with routine healingS82.036D
- Esubsequent encounter for open fracture type I or II with routine healingS82.036E
- Fsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healingS82.036F
- Gsubsequent encounter for closed fracture with delayed healingS82.036G
- Hsubsequent encounter for open fracture type I or II with delayed healingS82.036H
- Jsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingS82.036J
- Ksubsequent encounter for closed fracture with nonunionS82.036K
- Msubsequent encounter for open fracture type I or II with nonunionS82.036M
- Nsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunionS82.036N
- Psubsequent encounter for closed fracture with malunionS82.036P
- Qsubsequent encounter for open fracture type I or II with malunionS82.036Q
- Rsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionS82.036R
- SsequelaS82.036S
What Medicare edits apply to S82.036B?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S82.036B 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 S82.036B group to?
S82.036B sits in MDC 08 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.
- 562Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCCmedical
- 563Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without MCCmedical
As a secondary diagnosis, S82.036B 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 S82.036B listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S82.03, the nearest indexed parent of S82.036B. Use them to find the family, then select the specific code.
- Fracture, traumatic › patella › transverse (abduction) (adduction) (separation)
- Fracture, traumatic › patella › transverse › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S82
The conditions below can never be reported together with S82.036B on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- traumatic amputation of lower leg (S88.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S82.036B to fully describe the condition. S82.036B 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 S82.036B, but a patient may have both at the same time. When documentation supports it, S82.036B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S80-S89
The conditions below are not part of S82.036B, but a patient may have both at the same time. When documentation supports it, S82.036B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S82
The conditions below are not part of S82.036B, but a patient may have both at the same time. When documentation supports it, S82.036B and the excluded code may both be reported.
How long has S82.036B existed?
S82.036B has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.