S92.499A — Other fracture of unspecified great toe, initial encounter for closed fracture
Is S92.499A billable?
Yes, but S92.499A is an unspecified code. S92.499A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S92.499A is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting S92.499A — the more specific alternatives are listed below.
S92.499A at a glance
| Code | S92.499A |
|---|---|
| Description | Other fracture of unspecified great toe, 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 S92.499A?
In S92.499A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S92.499A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS92.499A
- Binitial encounter for open fractureS92.499B
- Dsubsequent encounter for fracture with routine healingS92.499D
- Gsubsequent encounter for fracture with delayed healingS92.499G
- Ksubsequent encounter for fracture with nonunionS92.499K
- Psubsequent encounter for fracture with malunionS92.499P
- SsequelaS92.499S
Which MS-DRGs does S92.499A group to?
S92.499A 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
How is S92.499A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S92.49, the nearest indexed parent of S92.499A. Use them to find the family, then select the specific code.
- Fracture, traumatic › toe › great › specified NEC (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S92.499A to fully describe the condition. S92.499A 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 S92.499A, but a patient may have both at the same time. When documentation supports it, S92.499A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S90-S99
The conditions below are not part of S92.499A, but a patient may have both at the same time. When documentation supports it, S92.499A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S92
The conditions below are not part of S92.499A, but a patient may have both at the same time. When documentation supports it, S92.499A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S92.4
The conditions below are not part of S92.499A, but a patient may have both at the same time. When documentation supports it, S92.499A and the excluded code may both be reported.
- Physeal fracture of phalanx of toe (S99.2-)
How long has S92.499A existed?
S92.499A 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.