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ICD-10 Guide
ICD-10 CodesS02.642

S02.642

Billable

Fracture of ramus of left mandible

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

Code Description

ICD-10 S02.642 is a billable code used to indicate a diagnosis of fracture of ramus of left mandible.

Key Diagnostic Point:

The fracture of the ramus of the left mandible refers to a break in the vertical portion of the mandible, which is crucial for the attachment of muscles involved in mastication and for the structural integrity of the jaw. This type of fracture can occur due to various mechanisms, including trauma from falls, sports injuries, or assaults. Clinical presentation typically includes pain, swelling, and difficulty in opening the mouth (trismus). Diagnosis is confirmed through imaging studies, primarily X-rays or CT scans, which help in assessing the fracture's location and displacement. Management often involves conservative treatment with pain control and dietary modifications, or surgical intervention in cases of significant displacement or instability. Complications may include malocclusion, infection, or 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 presentation and associated injuries
  • Need for precise documentation of laterality and specific location
  • Potential for multiple coding scenarios based on treatment approach
  • Differentiation from other mandibular fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify laterality
  • Incorrect coding of associated injuries or complications
  • Misinterpretation of imaging results

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include details of the injury mechanism, initial assessment findings, and any imaging performed.

Common Clinical Scenarios

Patients presenting with facial trauma after a motor vehicle accident or sports injury.

Billing Considerations

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

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of a displaced fracture requiring fixation plates or screws.

Billing Considerations

Document any pre-existing conditions that may affect healing or surgical outcomes.

Coding Guidelines

Inclusion Criteria

Use S02.642 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific nature and location of the fracture
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S02.642 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 performed for a fracture of the mandible.

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 procedure code.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, including laterality and specific locations, which enhances data accuracy and improves patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including laterality and specific locations, which enhances data accuracy and improves patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including laterality and specific locations, which enhances data accuracy and improves patient care tracking.

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 importance of specifying laterality in coding fractures?

Specifying laterality is crucial as it affects treatment decisions and reimbursement. It ensures accurate tracking of injury patterns and outcomes.