ICD-10 code S82.025G: Closed left patella fracture, delayed healing

Key takeaways

ICD-10 code S82.025G describes a nondisplaced longitudinal fracture of the left patella, coded at a subsequent encounter where a closed fracture is healing slowly.

The 7th character G means closed fracture with delayed healing. Open-fracture delayed healing uses H for Gustilo type I or II, and J for type IIIA, IIIB, or IIIC.

Delayed healing must be stated by the treating physician. Coders cannot infer it from elapsed time or from an imaging report alone.

The right-side sibling is S82.024G. S82.015 is not the right-side pair, because it describes an osteochondral fracture on the same left side.

Practice management software like Pabau ties the 7th character to the note behind it, so wound status and healing outcome are recorded before billing.

S82.025G is a billable ICD-10-CM diagnosis code valid for HIPAA-covered transactions. The CDC/NCHS ICD-10-CM web tool gives its base description as nondisplaced longitudinal fracture of left patella.

The 7th character supplies the rest. It marks a subsequent encounter for a closed fracture with delayed healing.

That closed-fracture detail is where claims are lost. The letter G never describes an open fracture. If the original injury broke the skin, the delayed-healing character is H or J instead.

Delayed healing also has to be stated by the physician. Elapsed time since the injury does not establish it, and neither does a radiology report on its own.

What S82.025G means: Breaking down the code

Every element of the description carries a coding consequence. Misread one and you select the wrong character or the wrong side. Here is what each part means at the desk.

• Nondisplaced. The fragments stay in anatomical alignment. The bone is broken but has not shifted. A displaced longitudinal fracture of the left patella takes S82.022 instead.
• Longitudinal. The fracture line runs parallel to the long axis of the patella. This vertical pattern is less common than a transverse break across the bone.
• Left patella. Laterality is built into the code. The right-side equivalent is S82.024G. Submitting S82.025G for a right knee is a laterality error.
• Subsequent encounter. Active definitive treatment of the fracture is finished. The patient is now in the healing and recovery phase of care.
• Closed fracture. The skin over the fracture was intact. No wound communicated with the fracture site at the time of the original injury.
• Delayed healing. The treating physician has documented that union is running behind the expected timeline for this fracture.

Coders working from the alphabetic index will find the base code under patella, and under fracture, patella, longitudinal. The quick reference below summarizes its billing status.

Understanding the 7th character ‘G’ in ICD-10 fracture codes

Every code in the S82 category needs a 7th character. It records three details at once. The character carries the encounter type, the wound status of the original injury, and the healing outcome.

Delayed healing splits three ways inside that set. G covers closed fractures. H covers open type I or II, and J covers open type IIIA, IIIB, or IIIC. The split follows the documented wound, not the length of the delay. The grid below shows where all 16 characters land.

Choosing the wrong character is one of the leading causes of denial on musculoskeletal claims. The same three-way split runs through the tibia shaft codes at S82.226G.

All valid 7th character extensions for S82.025

S82.025 has 16 valid 7th characters, and every one of them produces a billable code. The five-character base code S82.025 is never billable on its own.

The set runs from A to S, but the letters I, L and O are never used. That is why the sequence steps from H to J, from K to M, and from N to P.

S82.025G sits in the delayed-healing row for closed fractures. Its neighbor one row down covers the same delay after an open type I or II injury. For malunion in the same fracture family, compare S82.026P.

Clinical context: Nondisplaced longitudinal patella fractures and delayed healing

The patella is the largest sesamoid bone in the body, held inside the quadriceps tendon. It transmits the force of the extensor mechanism across the front of the knee.

A longitudinal fracture runs vertically, parallel to the long axis of the bone. It usually follows a direct blow to the front or the side of the knee. Transverse patterns are considerably more common.

The extensor mechanism often survives a nondisplaced vertical fracture intact. That is why conservative management is standard here. Immobilization in extension is followed by progressive range of motion and weight-bearing.

Nondisplaced patella fractures commonly unite within six to eight weeks. Delayed healing is raised when radiographs show incomplete callus well past that window, while union is still progressing. Several factors make a slow union more likely.

• Nicotine use. Smoking and vaping are consistently linked to slower bone union and higher nonunion rates.
• Metabolic factors. Diabetes, vitamin D deficiency and poor nutrition all reduce the bone repair response.
• Mechanical factors. Early unprotected knee flexion pulls the fragments apart through the extensor mechanism.
• Medication. Long-term corticosteroid use and some anti-inflammatory regimens can slow callus formation.

None of these belong in the code itself. They belong in the note that justifies it. Practices running post-fracture rehabilitation can capture them in physical therapy documentation.

When to use S82.025G: Subsequent encounter with delayed healing

Use S82.025G when all five of the following are documented for the same encounter.

• The injury is a nondisplaced longitudinal fracture of the patella.
• The note names the left knee or the left patella.
• The original fracture was closed, with intact skin over the fracture site.
• This visit is care during healing, not active definitive treatment.
• The physician states that healing is delayed or slower than expected.

Miss the wound status and the claim becomes a guess between G and H. Miss the laterality and the code is unsupported. Both are routine reasons a fracture claim comes back.

Delayed healing vs. nonunion vs. malunion in ICD-10 coding

The three healing complications are distinct clinical findings, and each has its own character. For a closed fracture in this family, the choice is between G, K and P.

Sequela takes the character S, and only after the healing phase has ended. A nondisplaced transverse patella fracture with a late residual effect is coded S82.036S.

Why Gustilo classification does not apply to S82.025G

The Gustilo-Anderson system grades the severity of open fractures. ICD-10-CM uses it directly in the 7th character set, so it comes up constantly in fracture coding.

It has no bearing on S82.025G. The letter G describes a closed fracture, and a closed fracture has no wound to grade. Gustilo type only matters once you are choosing between the open-fracture characters.

For delayed healing in this code family, that means H or J. The table below shows which characters each Gustilo type drives.

If the chart records an open patella fracture, take the Gustilo type from the initial operative or emergency note. Coders in sports medicine billing and orthopedics meet this distinction often.

Code hierarchy and parent codes

The hierarchy explains why the code runs to seven characters, and where to look when the note is less specific. S82.025G sits at the foot of the patella branch of the knee and lower leg block.

S82.025 by itself is not billable. A claim submitted without the 7th character is invalid, and it will reject at the clearinghouse or at the payer.

Related ICD-10 codes for patella fracture coding

The codes below are the ones most often confused with S82.025G. Two of them deserve particular attention, because they look like siblings and are not.

S82.015 is the code most often misfiled as the right-side pair for S82.025. It is not. S82.015 sits in the osteochondral subcategory S82.01, on the same left side, describing a different injury.

The right-side longitudinal family is S82.024, so the sibling for this encounter is S82.024G. Every code in the table still needs its own 7th character before it goes on a claim.

Excludes notes and coding exceptions for S82.025G

Category S82 carries both Excludes1 and Excludes2 notes. The difference between them decides whether two codes may appear together on the same claim.

• Excludes1: traumatic amputation of lower leg (S88.-). An Excludes1 note means the two conditions are never reported together for the same encounter.
• Excludes2: fracture of foot, except ankle (S92.-). Foot fractures belong to a separate category. Both may be coded when both are documented.
• Excludes2: periprosthetic fracture around an internal prosthetic knee implant (M97.1-). A fracture around a knee replacement is coded to M97.1-, not to S82.
• Physeal fractures. Growth plate injuries of the lower leg carry their own codes in S89, so confirm the anatomical site before you choose S82.

Excludes notes are revised alongside the tabular list each October. Verify a pairing in the current edition rather than trusting the version you used last year. The AAPC ICD-10-CM lookup is a quick way to cross-check.

Billing and documentation requirements

S82.025G is valid on the CMS-1500 for professional claims and on the UB-04 for institutional claims. Practices using claims management software can submit it electronically through an integrated clearinghouse.

Payers examine delayed-healing claims more closely than routine follow-up. Five documentation elements decide whether this one survives review.

• A physician statement of delayed healing. Wording such as healing slower than expected, or delayed union on imaging, satisfies this. Elapsed time on its own does not.
• Imaging interpreted in the note. Limited callus or a persistent fracture line should be described by the physician, not left inside the radiology report.
• Wound status of the original injury. The record must show the fracture was closed. Without it, no coder can defend G over H.
• Encounter type. The note must read as care during healing rather than active definitive treatment of the fracture.
• Laterality. A note that says patella fracture without naming the side cannot support a left-specific code.

Structured digital clinical forms keep all five elements in one place. Checking those templates against your medical billing compliance policies is the other half of the job.

Diagnosis placement follows the reason for the visit. List S82.025G first when the slow-healing fracture is why the patient is there. External cause codes from Chapter 20 are optional, though they strengthen the record.

Never quote a payment figure for a diagnosis code. Reimbursement depends on the procedure codes billed, the payer, and the locality on the current fee schedule.

Pabau sends electronic claims through our Claim.MD integration, covering CMS-1500 and 837P submission across thousands of US payers. Payments are reconciled from the electronic remittance advice on the same record.

ICD-9-CM crosswalk for S82.025G

Practices migrating legacy records still need the mapping back to ICD-9-CM. The CMS General Equivalence Mappings are the authoritative source, and every fracture mapping in them is approximate.

The mapping loses almost every detail the 7th character was designed to record. Treat the output as a starting point for research, never as a coding decision.

Official ICD-10-CM guidelines for fracture encounters

Chapter 19 of the ICD-10-CM Official Guidelines governs fracture coding across an episode of care. Four of its rules decide most S82.025G submissions.

• Aftercare Z codes do not apply to injuries. Report the acute fracture code with a subsequent encounter character instead of an aftercare code.
• The character follows the care, not the calendar. Active definitive treatment takes an initial encounter character, however long after the injury it happens.
• Delayed healing is a complication, not a sequela. Use G while the delay is being evaluated. Reserve S for a residual condition once healing has ended.
• Know the two defaults. A fracture not documented as open or closed is coded closed. A fracture not documented as displaced or nondisplaced is coded displaced.

That second default is the one that catches S82.025G. The word nondisplaced has to be in the note. Without it, the displaced code S82.022 is the correct default for a left longitudinal fracture.

The guidelines are republished with the tabular list each fiscal year, effective October 1. Reading the Chapter 19 fracture section before your annual coding refresh is the cheapest way to catch a change.

CPT codes commonly used with S82.025G

A diagnosis code generates no payment on its own. S82.025G supports the procedure codes billed at the same encounter, and those follow the services delivered.

Bone stimulation is subject to payer-specific coverage criteria. Confirm authorization before the device is supplied, rather than after the claim rejects.

Where to verify the code

Three sources carry the official tabular list and the guidance behind it. Check S82.025G against one of them before submission, then again after each October 1 update.

• The CDC/NCHS ICD-10-CM web tool publishes the official US tabular list, with searchable lookup by year.
• The CMS ICD-10 codes page carries the annual update files, including additions, deletions and revisions.
• The WHO ICD-10 browser gives the international hierarchy for context. US coders still bill from ICD-10-CM.

Fracture coding only holds up if the notes behind it do.

How Pabau supports accurate fracture coding

Fracture coding errors usually start in the clinical note. A clinician writes patella fracture, still healing, then moves on to the rehab plan.

The coder is left without the two details that decide the character. Was the original fracture open, and which knee was it? The claim then goes out on an assumption, and it can come back with one of the standard denial codes attached.

Practice management software like Pabau lets you attach documentation prompts to the codes your practice bills most often. A fracture follow-up note then asks for encounter type, wound status, pattern, laterality and healing outcome.

Pabau’s claims management carries that structured note through to submission, so the 7th character you send is the one the record supports. Your team spends less time reworking denials and more time with patients.

Claims management, medical records and reporting are included in every Pabau subscription. No tier locks the documentation templates away, so the whole practice works from the same prompts.

Catch fracture coding errors before they reach the payer

Pabau lets orthopedic and physical therapy teams build code-level documentation prompts into the encounter. Wound status and laterality mismatches surface when the note is completed, well before denial review.

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Conclusion

S82.025G is decided in the clinical note, not at the billing desk. One fact about it is worth pinning to the wall. The G stands for a closed fracture.

Get wound status, laterality, fracture pattern and healing outcome into every follow-up note. The 7th character then stops being the coder’s best guess, and the extension table becomes a lookup rather than a gamble.

Pabau’s claims management helps orthopedic and physical therapy practices build those prompts into the encounter workflow. Book a demo to see how it keeps fracture claims tied to the notes that support them.

Continue your research

Need a structured framework for fracture claim submissions? Clean claim submission guidelines covers what makes a claim error-free before it reaches the payer.

Working with orthopedic or physical therapy billing? Revenue cycle management overview explains how ICD-10 diagnosis coding fits into the full claims workflow.

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