S92.536B — Nondisplaced fracture of distal phalanx of unspecified lesser toe(s), initial encounter for open fracture
Is S92.536B billable?
Yes, but S92.536B is an unspecified code. S92.536B is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S92.536B 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 S92.536B — the more specific alternatives are listed below.
More specific alternatives
- S92.531BDisplaced fracture of distal phalanx of right lesser toe(s), initial encounter for open fracture
- S92.532BDisplaced fracture of distal phalanx of left lesser toe(s), initial encounter for open fracture
- S92.534BNondisplaced fracture of distal phalanx of right lesser toe(s), initial encounter for open fracture
- S92.535BNondisplaced fracture of distal phalanx of left lesser toe(s), initial encounter for open fracture
S92.536B at a glance
| Code | S92.536B |
|---|---|
| Description | Nondisplaced fracture of distal phalanx of unspecified lesser toe(s), 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 S92.536B?
In S92.536B, the 7th character B means initial encounter for open fracture. The 7th character is required for S92.536B to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS92.536A
- Binitial encounter for open fractureS92.536B
- Dsubsequent encounter for fracture with routine healingS92.536D
- Gsubsequent encounter for fracture with delayed healingS92.536G
- Ksubsequent encounter for fracture with nonunionS92.536K
- Psubsequent encounter for fracture with malunionS92.536P
- SsequelaS92.536S
Which MS-DRGs does S92.536B group to?
S92.536B 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 S92.536B listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S92.53, the nearest indexed parent of S92.536B. Use them to find the family, then select the specific code.
- Fracture, traumatic › toe › lesser › distal phalanx (abduction) (adduction) (separation)
- Fracture, traumatic › toe › lesser › distal phalanx › nondisplaced (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S92.536B to fully describe the condition. S92.536B 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 S92.536B, but a patient may have both at the same time. When documentation supports it, S92.536B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S90-S99
The conditions below are not part of S92.536B, but a patient may have both at the same time. When documentation supports it, S92.536B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S92
The conditions below are not part of S92.536B, but a patient may have both at the same time. When documentation supports it, S92.536B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S92.5
The conditions below are not part of S92.536B, but a patient may have both at the same time. When documentation supports it, S92.536B and the excluded code may both be reported.
- Physeal fracture of phalanx of toe (S99.2-)
How long has S92.536B existed?
S92.536B 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.