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S02.831D ICD-10-CM Code: Fracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing

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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)

S02.831D

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Fracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing

Fracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing

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
S02.83Fracture of medial orbital wall
S02.831Fracture of medial orbital wall, right side
S02.831DFracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing

Inclusion Terms

Official

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

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S02.831D in this effective period.

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
S02.831GFracture 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
S02.831SFracture of medial orbital wall, right side, sequela

Includes

Official

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

Excludes 1

Official

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

Code First

Official

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

Use Additional

Official

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

Code Also

Official

ICD-10-CM does not list Code Also instructions for S02.831D 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.

Is S02.831D an HCC code?

No. S02.831D is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

S02.831D is the ICD-10-CM diagnosis code for fracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing. S02.831D 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).

S02.831D is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

S02.831D is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing S02.831D should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S02.831D 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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