S82.53XM — Displaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type I or II with nonunion
Is S82.53XM billable?
Yes, but S82.53XM will trip a Medicare edit. S82.53XM is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S82.53XM 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
- S82.51XMDisplaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion
- S82.52XMDisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type I or II with nonunion
- S82.54XMNondisplaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion
- S82.55XMNondisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type I or II with nonunion
S82.53XM at a glance
| Code | S82.53XM |
|---|---|
| Description | Displaced fracture of medial malleolus of unspecified tibia, subsequent encounter for open fracture type I or II with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "M" | subsequent encounter for open fracture type I or II with nonunion |
What does the 7th character "M" mean in S82.53XM?
In S82.53XM, the 7th character M means subsequent encounter for open fracture type I or II with nonunion. The 7th character is required for S82.53XM to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS82.53XA
- Binitial encounter for open fracture type I or IIS82.53XB
- Cinitial encounter for open fracture type IIIA, IIIB, or IIICS82.53XC
- Dsubsequent encounter for closed fracture with routine healingS82.53XD
- Esubsequent encounter for open fracture type I or II with routine healingS82.53XE
- Fsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healingS82.53XF
- Gsubsequent encounter for closed fracture with delayed healingS82.53XG
- Hsubsequent encounter for open fracture type I or II with delayed healingS82.53XH
- Jsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingS82.53XJ
- Ksubsequent encounter for closed fracture with nonunionS82.53XK
- Msubsequent encounter for open fracture type I or II with nonunionS82.53XM
- Nsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunionS82.53XN
- Psubsequent encounter for closed fracture with malunionS82.53XP
- Qsubsequent encounter for open fracture type I or II with malunionS82.53XQ
- Rsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionS82.53XR
- SsequelaS82.53XS
What Medicare edits apply to S82.53XM?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S82.53XM 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 S82.53XM group to?
S82.53XM sits in MDC 08 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.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S82.53XM is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S82.53XM listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S82.5, the nearest indexed parent of S82.53XM. Use them to find the family, then select the specific code.
- Fracture, traumatic › ankle › medial malleolus (abduction) (adduction) (separation)
- Fracture, traumatic › ankle › medial malleolus › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S82
The conditions below can never be reported together with S82.53XM 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.-)
Excludes1 — never code together — inherited from S82.5
The conditions below can never be reported together with S82.53XM on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 19
Report an additional code alongside S82.53XM to fully describe the condition. S82.53XM 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 S82.53XM, but a patient may have both at the same time. When documentation supports it, S82.53XM and the excluded code may both be reported.
Excludes2 — not included here — inherited from S80-S89
The conditions below are not part of S82.53XM, but a patient may have both at the same time. When documentation supports it, S82.53XM and the excluded code may both be reported.
Excludes2 — not included here — inherited from S82
The conditions below are not part of S82.53XM, but a patient may have both at the same time. When documentation supports it, S82.53XM and the excluded code may both be reported.
How long has S82.53XM existed?
S82.53XM 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.