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ICD-10 Guide
ICD-10 CodesS02.6

S02.6

Billable

Fracture of mandible

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S02.6 is a billable code used to indicate a diagnosis of fracture of mandible.

Key Diagnostic Point:

A fracture of the mandible, or lower jaw, is a common injury that can occur due to various mechanisms, including trauma from falls, sports injuries, physical altercations, or vehicular accidents. The mandible is the largest and strongest bone of the face, and fractures can occur in different locations, including the body, angle, ramus, or condyle. Symptoms typically include pain, swelling, bruising, and difficulty in chewing or speaking. Diagnosis is primarily made through clinical examination and imaging studies such as X-rays or CT scans to assess the fracture's location and severity. Management may involve conservative treatment with pain control and dietary modifications or surgical intervention for more complex fractures requiring fixation. Complications can include malocclusion, infection, and nonunion of the fracture. Accurate coding is essential for proper reimbursement and tracking of injury patterns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of injury mechanism
  • Potential for associated injuries requiring additional codes
  • Differentiation from other facial fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the fracture type or location
  • Incorrect linkage of diagnosis to treatment procedures
  • Omission of associated injuries

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation should include a detailed account of the mechanism of injury, initial assessment findings, and any imaging results.

Common Clinical Scenarios

Trauma cases presenting with facial injuries, sports-related injuries, or assaults.

Billing Considerations

Ensure that all relevant injuries are documented, and consider the need for consultation with oral and maxillofacial surgery.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, fixation methods used, and any intraoperative findings.

Common Clinical Scenarios

Surgical repair of complex mandible fractures, including the use of plates and screws.

Billing Considerations

Document any complications encountered during surgery and the rationale for surgical intervention.

Coding Guidelines

Inclusion Criteria

Use S02.6 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type and location of the fracture
  • Document the mechanism of injury and any associated conditions accurately

Exclusion Criteria

Do NOT use S02.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21010CPT Code

Open treatment of mandible fracture

Clinical Scenario

Used when surgical intervention is required for a mandible fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oral and maxillofacial surgery documentation must be thorough.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mandible fractures, improving data accuracy and facilitating better tracking of injury patterns and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mandible fractures, improving data accuracy and facilitating better tracking of injury patterns and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mandible fractures, improving data accuracy and facilitating better tracking of injury patterns and treatment outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between S02.6 and S02.5?

S02.6 refers specifically to fractures of the mandible, while S02.5 pertains to fractures of the maxilla. Accurate coding requires distinguishing between these two facial bones.