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Specific ICD codes for Orbital Fractures effective Oct 1, 2019


Currently, there is only one diagnosis code is present for Orbital Fracture of floor, S02.3- Fracture of orbital floor, to report orbital bone fractures, and only one diagnosis code, S02.19 Other fracture of base of skull, to report orbital roof fractures.

Currently there is no code that allows you to specify which of the other three walls are injured of the orbit like,

1. Roof, 
2. Medial wall
3. Temporal wall

And now ICD-10-CM code book will be included several new codes that more clearly identify orbital fractures.

The new subcategories are,

Under new subcategory S02.12 Fracture of orbital roof, are new codes:

S02.121 Fracture of orbital roof, right side

S02.122 Fracture of orbital roof, left side

S02.129 Fracture of orbital roof, unspecified side

Under new subcategory S02.83 Fracture of medial orbital wall, are new codes:

S02.831 Fracture of medial orbital wall, right side

S02.832 Fracture of medial orbital wall, left side

S02.839 Fracture of medial orbital wall, unspecified side

Under new subcategory S02.84 Fracture of lateral orbital wall, are new codes:

S02.841 Fracture of lateral orbital wall, right side

S02.842 Fracture of lateral orbital wall, left side

S02.849 Fracture of lateral orbital wall, unspecified side

Under category S02.8 Fractures of other specified skull and facial bones, is one new code:

S02.85 Fracture of orbit, unspecified

Be More Specific:

To these fracture codes, add the appropriate seventh character to indicate encounter type,

A – Initial encounter for closed fracture

B – Initial encounter for open fracture

D – Subsequent encounter for fracture with routine healing

G – Subsequent encounter for fracture with delayed healing

K – Subsequent encounter for fracture with nonunion

S – Sequela

For S02.85, add a placeholder X in the sixth character position.

Click Here for overall changes


Coding Ahead

Code Orbital Fractures with Improved Clarity in 2020

Effective Oct. 1, 2019, ophthalmology coders will be able to report orbital roof and wall fractures with the utmost of specificity thanks to the creation of several new ICD-10-CM codes. Lack of Specificity Presents a Problem Presently, there is only one diagnosis code, S02.3- Fracture of orbital floor, to report orbital bone fractures, and only […]

The post Code Orbital Fractures with Improved Clarity in 2020 appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Orbital rim implants s/p cancer resection

The doctor put in two orbital implants and attached them to previously placed plates in patient’s eye orbit. The doctor wants to bill 67550 twice, since he put in two implants. However, I do not believe that this is quite correct since they were both done on the same eye and no separate incision was made. Any suggestions????

Medical Billing and Coding Forum