S92.226B — Nondisplaced fracture of lateral cuneiform of unspecified foot, initial encounter for open fracture
Is S92.226B billable?
Yes, but S92.226B will trip a Medicare edit. S92.226B is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S92.226B 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
- S92.221BDisplaced fracture of lateral cuneiform of right foot, initial encounter for open fracture
- S92.222BDisplaced fracture of lateral cuneiform of left foot, initial encounter for open fracture
- S92.224BNondisplaced fracture of lateral cuneiform of right foot, initial encounter for open fracture
- S92.225BNondisplaced fracture of lateral cuneiform of left foot, initial encounter for open fracture
S92.226B at a glance
| Code | S92.226B |
|---|---|
| Description | Nondisplaced fracture of lateral cuneiform of unspecified foot, initial encounter for open fracture |
| 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 |
What does the 7th character "B" mean in S92.226B?
In S92.226B, the 7th character B means initial encounter for open fracture. The 7th character is required for S92.226B to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS92.226A
- Binitial encounter for open fractureS92.226B
- Dsubsequent encounter for fracture with routine healingS92.226D
- Gsubsequent encounter for fracture with delayed healingS92.226G
- Ksubsequent encounter for fracture with nonunionS92.226K
- Psubsequent encounter for fracture with malunionS92.226P
- SsequelaS92.226S
What Medicare edits apply to S92.226B?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S92.226B 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 S92.226B group to?
S92.226B 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, S92.226B 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 S92.226B listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S92.22, the nearest indexed parent of S92.226B. Use them to find the family, then select the specific code.
- Fracture, traumatic › tarsal bone › cuneiform › lateral (abduction) (adduction) (separation)
- Fracture, traumatic › tarsal bone › cuneiform › lateral › nondisplaced (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S92.226B to fully describe the condition. S92.226B 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 S92.226B, but a patient may have both at the same time. When documentation supports it, S92.226B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S90-S99
The conditions below are not part of S92.226B, but a patient may have both at the same time. When documentation supports it, S92.226B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S92
The conditions below are not part of S92.226B, but a patient may have both at the same time. When documentation supports it, S92.226B and the excluded code may both be reported.
How long has S92.226B existed?
S92.226B 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.