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S92.536 ICD-10-CM Code: Nondisplaced fracture of distal phalanx of unspecified lesser toe(s)

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the ankle and foot (S90-S99)

S92.536

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

Nondisplaced fracture of distal phalanx of unspecified lesser toe(s)

Nondisplaced fracture of distal phalanx of unspecified lesser toe(s)

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

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Code Book Path

Official
S92.5Fracture of lesser toe(s)
S92.53Fracture of distal phalanx of lesser toe(s)
S92.536Nondisplaced fracture of distal phalanx of unspecified lesser toe(s)

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S92.536 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S92.536 in this effective period.

Related Child Codes

Official
S92.536ANondisplaced fracture of distal phalanx of unspecified lesser toe(s), initial encounter for closed fracture
S92.536BNondisplaced fracture of distal phalanx of unspecified lesser toe(s), initial encounter for open fracture
S92.536DNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with routine healing
S92.536GNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with delayed healing
S92.536KNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with nonunion

Includes

Official

ICD-10-CM does not list Includes notes for S92.536 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S92.536 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S92.536 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S92.536 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S92.536 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

S92.536 is the ICD-10-CM diagnosis code for nondisplaced fracture of distal phalanx of unspecified lesser toe(s). S92.536 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 ankle and foot (s90-s99).

Header codes like S92.536 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 S92.536'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 S92.536 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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