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ICD-10 Guide
ICD-10 CodesS02.60

S02.60

Billable

Fracture of mandible, unspecified

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

Code Description

ICD-10 S02.60 is a billable code used to indicate a diagnosis of fracture of mandible, unspecified.

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, assaults, or vehicular accidents. The mandible is the largest and strongest bone of the face, and fractures can lead to significant functional impairment, including difficulties in chewing, speaking, and maintaining oral hygiene. The unspecified nature of this code indicates that the specific location or type of fracture (e.g., body, ramus, angle) is not documented. Clinically, patients may present with pain, swelling, bruising, and malocclusion. Diagnosis typically involves a thorough clinical examination and imaging studies, such as X-rays or CT scans, to assess the fracture's extent and any associated injuries. Management may include conservative treatment with pain control and dietary modifications or surgical intervention for more complex fractures. Complications can include infection, nonunion, malunion, and damage to adjacent structures such as teeth or nerves.

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 fracture specifics
  • Failure to capture associated injuries
  • Misuse of unspecified codes leading to potential denials
  • Lack of clarity in mechanism of injury

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the mechanism of injury, clinical findings, and any imaging results.

Common Clinical Scenarios

Patients presenting with facial trauma from falls or assaults requiring immediate assessment and imaging.

Billing Considerations

Ensure that all relevant injuries are documented to support the use of additional codes.

Surgery

Documentation Requirements

Operative reports should detail the surgical approach, fixation methods, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical repair of mandible fractures following trauma, including fixation with plates or screws.

Billing Considerations

Accurate coding of surgical procedures must align with the diagnosis of the fracture.

Coding Guidelines

Inclusion Criteria

Use S02.60 When
  • Follow ICD
  • CM guidelines for coding injuries, ensuring that the mechanism of injury is documented and that any associated injuries are captured with additional codes

Exclusion Criteria

Do NOT use S02.60 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21010CPT Code

Closed treatment of mandible fracture

Clinical Scenario

Used when a closed reduction is performed for an unspecified mandible fracture.

Documentation Requirements

Document the procedure performed, including any imaging and follow-up care.

Specialty Considerations

Emergency and surgical specialties should ensure accurate coding of the procedure in relation to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of fractures, improving specificity and accuracy in capturing the nature of injuries. However, the use of unspecified codes like S02.60 can lead to potential audit risks if not properly documented.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of fractures, improving specificity and accuracy in capturing the nature of injuries. However, the use of unspecified codes like S02.60 can lead to potential audit risks if not properly documented.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of fractures, improving specificity and accuracy in capturing the nature of injuries. However, the use of unspecified codes like S02.60 can lead to potential audit risks if not properly documented.

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

When should I use S02.60 instead of a more specific code?

Use S02.60 when the specific location or type of mandible fracture is not documented. However, strive to obtain more specific information to enhance coding accuracy.