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S02.831 ICD-10-CM Code: Fracture of medial orbital wall, right side

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the head (S00-S09)

S02.831

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Fracture of medial orbital wall, right side

Fracture of medial orbital wall, right side

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
S02.8Fractures of other specified skull and facial bones
S02.83Fracture of medial orbital wall
S02.831Fracture of medial orbital wall, right side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S02.831 in this effective period.

Excludes 2

Official
  • orbital floor (S02.3-)
  • orbital roof (S02.12-)

Related Child Codes

Official
S02.831AFracture of medial orbital wall, right side, initial encounter for closed fracture
S02.831BFracture of medial orbital wall, right side, initial encounter for open fracture
S02.831DFracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing
S02.831GFracture of medial orbital wall, right side, subsequent encounter for fracture with delayed healing
S02.831KFracture of medial orbital wall, right side, subsequent encounter for fracture with nonunion

Includes

Official

ICD-10-CM does not list Includes notes for S02.831 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S02.831 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S02.831 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S02.831 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S02.831 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

S02.831 is the ICD-10-CM diagnosis code for fracture of medial orbital wall, right side. S02.831 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the head (s00-s09).

Header codes like S02.831 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at S02.831's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S02.831 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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