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ICD-10 Guide
ICD-10 CodesS02.64

S02.64

Billable

Fracture of ramus of mandible

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

Code Description

ICD-10 S02.64 is a billable code used to indicate a diagnosis of fracture of ramus of mandible.

Key Diagnostic Point:

The ramus of the mandible is a vertical portion of the lower jaw that connects to the skull at the temporomandibular joint. A fracture in this area can occur due to various mechanisms of injury, including blunt trauma from falls, motor vehicle accidents, or physical altercations. Symptoms typically include pain, swelling, and difficulty in opening the mouth or chewing. Diagnosis is often confirmed through imaging studies such as X-rays or CT scans, which can reveal the extent and nature of the fracture. Management may involve conservative treatment with pain control and dietary modifications, or surgical intervention if the fracture is displaced or involves the joint. Complications can include malocclusion, infection, or nonunion of the fracture. Accurate coding is essential for proper reimbursement and tracking of injury patterns in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types (e.g., simple vs. complex fractures)
  • Need for precise documentation of the mechanism of injury
  • Potential for associated injuries in the facial region
  • Differentiation from other mandibular fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify whether the fracture is open or closed
  • Misclassification of the fracture type
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Complete documentation of the patient's history, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with facial trauma after a fall or assault.

Billing Considerations

Ensure that the mechanism of injury is clearly documented to support the diagnosis.

Surgery

Documentation Requirements

Detailed operative reports including the type of surgical intervention performed.

Common Clinical Scenarios

Surgical repair of a displaced ramus fracture.

Billing Considerations

Document any complications or additional procedures performed during surgery.

Coding Guidelines

Inclusion Criteria

Use S02.64 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the specific type of fracture and its location
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S02.64 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 ramus fracture.

Documentation Requirements

Operative report detailing the procedure performed.

Specialty Considerations

Ensure that the surgical approach and any complications are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, including those of the ramus of the mandible, improving data accuracy and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including those of the ramus of the mandible, improving data accuracy and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 an open and closed fracture of the ramus?

An open fracture involves a break in the skin and exposure of the bone, while a closed fracture does not involve any skin breach. Accurate documentation of this distinction is crucial for coding.