ICD code S82.031A – Displaced transverse fracture of right patella

Key takeaways

S82.031A covers a displaced transverse fracture of the right patella at an initial closed-fracture encounter. The left-side code is S82.032A and the non-displaced equivalent is S82.034A.

7th character A applies only while the patient is receiving active treatment. Use D for routine follow-up during healing, and S for late effects such as post-fracture arthritis.

Payers routinely deny S82.031A when the coder falls back to the unspecified-laterality code S82.033A, or when the radiology report never confirms displacement. Both are worth a provider query.

Practice management software like Pabau flags missing or mismatched claim details before submission, which cuts the manual auditing load on orthopedic billing teams.

ICD-10 Code S82.031A: Quick reference

ICD-10 Code S82.031A is the billable diagnosis code for a displaced transverse fracture of the right patella, initial encounter for closed fracture.

It applies while the patient is still under active treatment for that fracture. The record has to document the transverse pattern, the displacement and the right side. The table below captures every field a coder verifies before the claim goes out.

Anatomy of ICD-10 Code S82.031A: Character-by-character breakdown

ICD-10 Code S82.031A is a seven-character code where each position encodes a distinct clinical fact. Misreading any single character is enough to trigger a payer edit. The table below decodes each position.

The sixth character is where most coding errors originate. “1” encodes a displaced fracture of the right patella, while “4” encodes the non-displaced version on the same side. If the radiology report does not explicitly state that fragments have separated, the coder must query the provider before assigning S82.031A rather than S82.034A.

Choosing the 7th character for S82.031A: A, D, S and the full extension set

The 7th character is the most frequently miscoded element in patella fracture claims. Per the ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), “A” applies as long as the patient is receiving active treatment. The number of prior visits does not change that. Selecting “D” on an initial emergency department visit is one of the most common sources of denial on this code. Encounter type follows the treatment phase, not the number of visits already billed.

Open fracture note: An open wound at the fracture site replaces character A with B or C in the code. Which of the two applies depends on the Gustilo-Anderson classification (type I/II versus IIIA/B/C), which must be documented first. Defaulting to A on an open fracture is clinically inaccurate and a compliance risk under CMS guidelines.

S82.031A vs S82.031D vs S82.031S: Choosing the correct episode-of-care suffix

S82.031A, S82.031D, and S82.031S describe the same fracture at three different clinical moments. Confusion between A and D accounts for a significant share of initial denials on patella fracture claims. The timeline below follows one right patella fracture from the emergency visit through to a late complication.

• S82.031A (initial encounter, closed): Use from first contact through the end of active treatment. That includes the surgery date, all pre-operative visits, and the first post-operative wound check while treatment is still active. A patient seen in the ED on Monday and again by the surgeon on Thursday is still in the initial phase.
• S82.031D (subsequent encounter, routine healing): Use once active treatment decisions are complete and the patient is on a monitoring or rehabilitation pathway. A 6-week follow-up X-ray to confirm healing progress is a classic D encounter.
• S82.031S (sequela): Use for conditions that arise as a direct result of the healed fracture. Post-fracture chondromalacia or chronic knee pain takes S82.031S as a secondary code, with the sequela condition as the principal diagnosis.

Common coder mistake: Assigning D on the first orthopedic visit because it is a “follow-up” after the ED. If the orthopedist is formulating a treatment plan at that visit, the encounter is still an initial one. Ordering surgery, applying a cast, and prescribing weight-bearing restrictions all count as active treatment.

Displaced vs non-displaced patella fracture ICD-10: Which code applies?

Displaced and non-displaced fractures of the right patella share the same anatomical location but require different codes. They also require different documentation to support them, and displacement status has to come from the radiology or operative report rather than from clinical inference.

Per ICD-10-CM Official Guidelines, when documentation is ambiguous between displaced and non-displaced, coders should query the provider rather than default to the non-displaced code. Displacement is clinically meaningful, since it usually drives the choice between surgical and conservative treatment. Payers may also audit the CPT code pairing against the displacement status in the ICD-10 code.

Right vs left patella: S82.031A vs S82.032A and laterality errors

Laterality is mandatory in ICD-10-CM. S82.031A encodes the right patella and S82.032A encodes the left. The unspecified laterality code S82.033A is an automatic denial trigger with most commercial payers and Medicare. Reach for it only when the imaging report does not identify the injured knee.

• S82.031A: Displaced transverse fracture, right patella, initial encounter
• S82.032A: Displaced transverse fracture, left patella, initial encounter
• S82.033A: Displaced transverse fracture, unspecified patella, initial encounter — avoid when the side is documented

Documentation tip: Always confirm laterality from the radiology report header, not the clinical note alone. Operative notes occasionally reference the contralateral limb for comparison, which can introduce laterality confusion during coding. Cross-reference the X-ray or MRI impression for the definitive side statement before assigning the code. Laterality errors sit among the top five denial codes on orthopedic claims.

CPT codes commonly paired with S82.031A

The CPT code selected must match the documented procedure and the fracture’s displacement status in the ICD-10 code. Pairing a surgical open-reduction CPT with a non-displaced ICD-10 code is an audit flag. So is billing a closed treatment CPT with S82.031A after open surgery. Confirm every CPT pairing against the operative report before submitting. Practices that track these pairings systematically use software built for cleaner claims management, which surfaces CPT-ICD mismatch edits before claims leave the practice.

Upcoding risk: CPT 27524 (open treatment with internal fixation) billed alongside a non-displaced code such as S82.034A raises a red flag. Non-displaced transverse patella fractures are rarely treated with open reduction internal fixation as a first-line intervention. Payers may request the operative note to confirm medical necessity when this pairing appears.

Documentation requirements for S82.031A

The medical record must support every dimension of ICD-10 Code S82.031A before the claim is submitted. A missing element gives payers grounds to deny or downcode. A documentation checklist built into the clean claim workflow catches the omission before submission rather than during appeal. Here is what the record must contain:

• Fracture pattern: The radiology report must identify the fracture as transverse, meaning a horizontal disruption of the patellar body. “Patella fracture” without pattern specificity is insufficient, so the coder queries the radiologist or the ordering provider.
• Displacement confirmation: The report must state “displaced” or describe fragment separation. A measurement of separation distance, such as “3 mm fragment displacement”, satisfies this requirement.
• Laterality: “Right knee” or “right patella” must appear explicitly in the imaging impression or operative note, not only in the clinical history section.
• Encounter type: The note must document active treatment decisions being made at this visit. A triage note, a surgical plan, or a cast application record all support 7th character A.
• Closed vs open: If the skin is intact, “closed fracture” is the default. If an open wound communicates with the fracture, the note must document the wound and the Gustilo-Anderson classification to support characters B or C.

When provider documentation is silent on fracture pattern or displacement, the coder should issue a provider query before assigning S82.031A. Coding from inference rather than documentation is a compliance violation. Pabau supports electronic claim submission through Claim.MD, our US clearinghouse partner, which processes CMS-1500 and 837P claims for thousands of US payers. It also flags missing or conflicting diagnosis fields before the claim is transmitted.

Common claim denial reasons for S82.031A and how to fix them

Most denials on ICD-10 Code S82.031A are preventable. The table below maps the five most common denial reasons to their root cause and corrective action. After a denial, read the CARC code on the remittance advice before deciding whether to appeal or recode.

Related patella fracture codes: The S82.0 code block

S82.031A is one entry in the S82.0 patella fracture family. Coders working across several fracture presentations in the same patient population benefit from keeping this reference block in view. The same character logic governs every code in it: chapter, anatomy, pattern, laterality, encounter type. The AAPC ICD-10-CM lookup and the ICD List tool provide full tabular navigation for the S82 block.

How Pabau keeps orthopedic fracture claims clean before submission

In most orthopedic practices the coding check happens twice, and both times by hand. A coder reads the operative note and the imaging impression, assigns S82.031A, and a biller re-reads the same record before the batch goes out. Anything either of them misses surfaces weeks later as a denial, when the encounter is cold and the notes take longer to reconstruct.

Pabau, our practice management software, keeps the imaging report, the operative note and the coded diagnosis on one patient record. The coder stops chasing documents across systems. The billing workflow flags missing or mismatched claim details before submission, and claims go out electronically through Claim.MD to thousands of US payers.

For a fracture-heavy caseload that means a shorter review cycle. Fewer claims come back over a detail that was in the chart all along. Every subscription includes the full feature set, so a two-surgeon practice runs the same claims workflow as a multi-site group.

Reduce claim denials on orthopedic fracture codes

Pabau’s billing workflow flags missing or mismatched claim details before submission, so your orthopedic claims reach payers clean the first time.

Book a demo

Conclusion

ICD-10 Code S82.031A is precise, and the precision is what makes it denial-prone. Three elements have to line up on every claim: a transverse pattern with confirmed displacement, right-side laterality, and an encounter that qualifies as active treatment. When one of them is missing or ambiguous, the claim comes back.

A provider query before submission costs a coder a few minutes. An appeal six weeks later costs far more, and the money sits unpaid while it runs. Build the pattern, displacement and laterality checks into the pre-submission review, and most of this code’s denial volume disappears. Book a demo to see how Pabau handles orthopedic claims from coding through to remittance.

Continue your research

Need guidance on denial management workflows? Denial management in healthcare covers systematic approaches to reducing claim rejection rates across billing teams.

Want to understand how clearinghouses validate claims? Medical claims clearinghouse explains how 837P files are validated before they reach payers.

Reading a denial on the remittance? Electronic remittance advice walks through the CARC and RARC codes that tell you why a claim was cut.

Looking for a billing compliance framework? Revenue cycle management fundamentals outlines the end-to-end process from coding through payment posting.

Frequently asked questions