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ICD-10 Guide
ICD-10 CodesS02.62

S02.62

Billable

Fracture of subcondylar process of mandible

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

Code Description

ICD-10 S02.62 is a billable code used to indicate a diagnosis of fracture of subcondylar process of mandible.

Key Diagnostic Point:

The subcondylar process of the mandible is a critical area that connects the mandible to the skull via the temporomandibular joint (TMJ). Fractures in this region can occur due to various mechanisms, including direct trauma from falls, motor vehicle accidents, or physical altercations. Clinically, patients may present with pain, swelling, and limited jaw movement, often accompanied by malocclusion or difficulty in chewing. Diagnosis typically involves a thorough clinical examination and imaging studies, such as X-rays or CT scans, to assess the fracture's extent and displacement. Management may include conservative treatment with analgesics and soft diet or surgical intervention for more severe fractures requiring fixation. Complications can include nonunion, malocclusion, and TMJ dysfunction, necessitating careful follow-up and potential rehabilitation. Accurate coding is essential for proper reimbursement and tracking of treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture presentation and severity
  • Need for imaging interpretation
  • Potential for associated injuries in polytrauma cases
  • Differentiation from other mandibular fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (e.g., open vs. closed)
  • Misclassification of fracture location
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Complete documentation of initial assessment, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with facial trauma from accidents or assaults.

Billing Considerations

Ensure detailed documentation of the mechanism of injury and any associated injuries.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of displaced fractures requiring fixation.

Billing Considerations

Document any complications or additional procedures performed during surgery.

Coding Guidelines

Inclusion Criteria

Use S02.62 When
  • Follow ICD
  • CM guidelines for coding fractures, including specificity regarding the location, type, and whether the fracture is open or closed
  • Ensure to document the mechanism of injury as it may affect coding

Exclusion Criteria

Do NOT use S02.62 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21026CPT Code

Open treatment of mandibular fracture

Clinical Scenario

Used when surgical intervention is required for a fracture of the subcondylar process.

Documentation Requirements

Operative report detailing the procedure, fixation method, and any complications.

Specialty Considerations

Ensure that the surgical approach is clearly documented to support the CPT code.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, including the subcondylar process, which aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, including the subcondylar process, which aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding fractures, including the subcondylar process, which aids in better tracking of treatment outcomes and resource allocation.

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 primary mechanism of injury for a subcondylar fracture?

The primary mechanism is typically direct trauma, such as from falls, physical altercations, or motor vehicle accidents.

How can I differentiate between a subcondylar fracture and other mandibular fractures?

Clinical examination and imaging studies are essential. Subcondylar fractures often present with specific symptoms like limited jaw movement and pain localized to the TMJ area.