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ICD-10 Guide
ICD-10 CodesChapter 19: Injury, poisoning and other consequences of external causesS92

S92

Non-billable

Fracture of foot and toe, except ankle

Chapter 19:Injury, poisoning and other consequences of external causes

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 S92 is a used to indicate a diagnosis of fracture of foot and toe, except ankle.

Key Diagnostic Point:

The ICD-10 Level 1 Category code S92 encompasses fractures of the foot and toe, excluding the ankle region. This category includes a variety of specific fracture types such as metatarsal fractures, phalangeal fractures, and other related injuries. These fractures can result from various mechanisms, including trauma, falls, sports injuries, or repetitive stress. Clinically, these fractures may present with pain, swelling, bruising, and difficulty in weight-bearing, necessitating thorough evaluation and management to ensure proper healing and function restoration.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of fracture types
  • Potential for complications
  • Need for imaging studies

Audit Risk Factors

  • Inaccurate coding of fracture type
  • Insufficient documentation of injury mechanism
  • Failure to capture associated complications

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Podiatry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of S92 codes is significant, as accurate coding can influence treatment decisions and patient outcomes. Proper documentation and coding can also affect quality measures and performance metrics in healthcare settings. Administratively, these codes play a role in tracking population health trends related to musculoskeletal injuries, which can inform preventive strategies and resource allocation in healthcare systems.

ICD-9 vs ICD-10

The clinical impact of S92 codes is significant, as accurate coding can influence treatment decisions and patient outcomes. Proper documentation and coding can also affect quality measures and performance metrics in healthcare settings. Administratively, these codes play a role in tracking population health trends related to musculoskeletal injuries, which can inform preventive strategies and resource allocation in healthcare systems.

Reimbursement & Billing Impact

Reimbursement may depend on the documentation of the injury's severity, the treatment rendered, and any follow-up care necessary. It is essential to provide clear and comprehensive documentation that supports the medical necessity of the services billed, including any imaging studies or surgical interventions performed.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for S92

Coding & Billing References

  • •
    Official ICD-10 Guidelines for S92

Frequently Asked Questions

What conditions are included in S92?

Conditions included in S92 are fractures of the metatarsals, phalanges, and other bones of the foot, excluding the ankle. This may involve both acute fractures and stress fractures.

When should I use S92 codes?

S92 codes should be used when documenting fractures of the foot and toes that are not related to the ankle. It is important to specify the exact location and type of fracture for accurate coding.

What documentation is required for S92?

Documentation for S92 should include the type of fracture, the mechanism of injury, any associated complications, and the treatment plan. Imaging results and clinical assessments should also be included.