ICD code S82.122R – Displaced left tibial lateral condyle fracture

Key takeaways

S82.122R is a billable ICD-10-CM code, valid for fiscal year 2026, for a displaced fracture of the left tibial lateral condyle.

The 7th character R encodes three facts at once: subsequent encounter, open fracture type IIIA, IIIB or IIIC, and malunion.

All three must be documented. If any one is missing, a different sibling code in the S82.122 family applies instead.

Malunion and nonunion are separate healing outcomes with separate codes, and imaging alone cannot settle which one the physician has diagnosed.

Pabau’s claims management software integrates with Claim.MD to validate ICD-10-CM codes at submission and route clean claims to thousands of US payers.

What is ICD-10 Code S82.122R?

ICD-10 Code S82.122R is a billable ICD-10-CM diagnosis code for a follow-up visit after a displaced fracture of the left tibial lateral condyle. The original injury was an open fracture, graded Gustilo type IIIA, IIIB, or IIIC, and it has since healed in an abnormal position.

Initial encounter codes, the suffixes A, B, and C, cover active treatment. S82.122R applies only once that treatment is complete and the patient returns for ongoing management of the healing complication. Medicare, Medicaid, and commercial payers accept it for reimbursement when documentation supports every component of the full description.

The code is active and valid for the 2025 and 2026 fiscal years with no scheduled revision. It sits within the S82 category for fractures of the lower leg, alongside tibial shaft, fibular, and bimalleolar fractures.

Understanding the 7th character ‘R’ in S82.122R

The 7th character in ICD-10-CM fracture codes carries three pieces of clinical information at once. It records the encounter phase, the fracture type and its Gustilo grade, and the healing outcome.

For S82.122R, the character R combines subsequent encounter, open type IIIA/IIIB/IIIC, and malunion. All three must be present in the clinical record. The grid below maps every suffix in the S82.122 family onto the two facts that decide it.

The full 7th character table for the S82.122 code family is below. Use it alongside physician documentation to confirm the suffix before submitting a claim.

S82.122 code family: All 7th character variants

The S82.122 family covers every encounter type and healing outcome for a displaced fracture of the lateral condyle of the left tibia. The table below maps each sibling code. Check it before submitting to Medicare or a commercial payer, and verify against the CDC/NCHS ICD-10-CM web tool for the current fiscal year.

S82.122R code hierarchy in ICD-10-CM

S82.122R sits at the sixth level of the ICD-10-CM hierarchy. Understanding the structure helps coders confirm specificity and find adjacent codes when documentation is incomplete. The tabular list moves from broad injury chapters down to codes specific by site, laterality, and encounter.

• S00-T88: Injury, poisoning and certain other consequences of external causes
• S80-S89: Injuries to the knee and lower leg
• S82: Fracture of lower leg, including ankle
• S82.1: Fracture of upper end of tibia
• S82.12: Fracture of lateral condyle of tibia
• S82.122: Displaced fracture of lateral condyle of left tibia
• S82.122R: Subsequent encounter, open type IIIA/IIIB/IIIC, malunion

If the fracture is on the right side, the correct parent is S82.121 rather than S82.122. If displacement is not documented, move to S82.125 for the left nondisplaced variant.

Gustilo-Anderson classification and ICD-10 Code S82.122R

The Gustilo-Anderson classification is the clinical framework ICD-10-CM uses to distinguish open fracture severity. Per AAPC ICD-10-CM coding guidance, coders must identify the Gustilo type from operative or clinical notes before assigning an open-fracture 7th character. The type cannot be inferred from imaging or assumed from the mechanism of injury.

The operative report is the primary source for Gustilo type. Documentation of a high-energy open fracture with extensive soft tissue loss requiring flap coverage points to type IIIB.

Where the type is stated outright, use the stated classification. Coders should query the physician when documentation is ambiguous rather than defaulting to a lower grade.

Malunion vs nonunion: Choosing the right ICD-10 fracture code

Malunion and nonunion are the two most commonly confused healing outcomes in fracture coding. For an open type IIIA/IIIB/IIIC left tibial condyle fracture, the choice is between S82.122R and S82.122N. Both are billable, but they describe clinically distinct situations and pair with different surgical CPT codes.

ICD-10-CM coding conventions require coders to work from physician-documented diagnoses. Never upgrade a note of delayed healing to nonunion or malunion based on the number of weeks since injury.

When to use S82.122R: Documentation checklist

Every element below must be confirmed in the clinical record before assigning ICD-10 Code S82.122R. A single missing element shifts the code to a different sibling or requires a physician query.

• Laterality confirmed as left: the right-side equivalent is S82.121x, and bilateral fractures require separate codes for each side
• Fracture site is the lateral condyle of the tibia: not the medial condyle (S82.13x), the tibial plateau more broadly, or the tibial shaft (S82.2x)
• Displacement documented: “displaced” must appear in the physician’s diagnosis, and where it is not stated, the nondisplaced left code S82.125x applies instead
• Subsequent encounter confirmed: active treatment is complete, and the patient is returning for management of healing complications, physical therapy follow-up, or monitoring
• Open fracture grade stated as IIIA, IIIB, or IIIC: documented in the original operative note or carried forward in the treatment record. Where the grade is type I or II, S82.122Q is the malunion code instead
• Malunion explicitly documented: the physician has recorded malunion as the current healing status, and imaging findings alone do not qualify

The AHA Coding Clinic for ICD-10-CM/PCS is the definitive source for scenario-specific guidance when documentation does not map cleanly to a single code. Review the relevant quarterly issues on tibial fracture coding before finalizing complex cases.

ICD-10-CM coding guidelines for fracture subsequent encounters

The ICD-10-CM Official Guidelines for Coding and Reporting are published annually by the NCHS and CMS. They set the rules for fracture subsequent encounters in Chapter 19. The points that matter most for S82.122R are these:

• Active treatment vs aftercare: subsequent encounter codes (7th character D through S) cover routine care during the healing or recovery phase. Initial encounter codes A, B, and C cover active treatment, including definitive surgery and a new provider taking over care.
• Sequela (S) is not subsequent: sequela codes apply to late effects after the fracture has healed, such as post-traumatic arthritis. Do not use S82.122S while the malunion is still being managed clinically.
• Healing status drives the suffix: the suffix reflects healing status at the time of the encounter, not at the time of injury. A fracture can move from delayed healing (J) to nonunion (N) or malunion (R) across visits.
• Laterality and displacement come from the original injury record: these do not change with healing. Subsequent encounters keep the same laterality and displacement qualifiers the initial encounter established.

The CMS ICD-10-CM coding guidelines page publishes the full guidelines document for each fiscal year. Download the current version before coding complex fracture cases, because minor rule clarifications appear in the annual update.

Billing and reimbursement for S82.122R

S82.122R is accepted by Medicare, Medicaid, and most commercial payers when it is paired with a clinically appropriate CPT procedure code. For malunion repair of a tibial condyle fracture, coders commonly pair the diagnosis with CPT codes for osteotomy or revision internal fixation. Verify the pairing against current NCCI edit tables before submitting.

Practice management software like Pabau submits claims electronically through Claim.MD, routing ICD-10-CM coded claims to thousands of US payers including Medicare and Medicaid. Codes are validated at submission, and ERA remittance data returns to the practice so reimbursements can be reconciled quickly.

For orthopedic and musculoskeletal practices, the most common denial pattern on subsequent encounter claims is an initial encounter code submitted for a follow-up visit. Catching it before the claim leaves the practice is cheaper than appealing it afterwards.

Common denial triggers for S82.122R and its siblings include:

• Using an initial encounter suffix (A, B, or C) on a follow-up visit
• Submitting a closed-fracture suffix (D, G, K, P) when operative notes document an open fracture
• Missing Gustilo type documentation in the chart, leading to a query hold before claim release
• Selecting malunion (R) when the physician documented nonunion (N), or the reverse

A systematic process catches these errors before they reach the payer. Our guide to denial management sets out how practices build one, from the first rejection through to appeal.

Related ICD-10 codes to know alongside S82.122R

The codes below are the most clinically adjacent to S82.122R. Verify laterality, displacement, and encounter type against the clinical scenario before selecting any of them. Our diagnostic codes library carries a reference page for each one. The ICD List lookup tool confirms current code validity and descriptions for the active fiscal year.

How practice management software supports accurate ICD-10 coding

Orthopedic and musculoskeletal practices face a particular coding challenge. The 7th character changes at every visit as healing status progresses. The original Gustilo type also has to travel accurately through the whole episode of care. A documentation error on the initial encounter note cascades through every later code for that patient.

Pabau’s claims management software connects to the Claim.MD clearinghouse and applies built-in CPT and ICD-10-CM catalogs at submission. Codes are checked before the claim leaves the practice, so a mismatch surfaces while the chart is still open.

For a code like S82.122R, where five clinical parameters must align, that timing matters. Correcting the record at the point of coding avoids an appeal weeks later.

Structured encounter notes carry the original fracture type, laterality, and displacement into every follow-up visit template. That removes the manual step of re-reading the initial operative note each time a subsequent encounter code is assigned.

Reduce claim denials on complex fracture codes

Pabau’s claims management software validates ICD-10-CM codes at submission and routes clean claims through Claim.MD to thousands of US payers. See how orthopedic and musculoskeletal practices connect coding and reimbursement in one system.

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Conclusion

Assigning ICD-10 Code S82.122R correctly depends on five documented facts aligning in the record. Those are the left lateral condyle, displacement, a subsequent encounter, open type IIIA/IIIB/IIIC, and malunion.

Miss one and the claim carries a different sibling code, with different reimbursement and a different denial risk. The practical safeguard is a follow-up note template that carries the initial encounter’s facts forward. The coder then never has to reconstruct them from an operative report.

Book a demo to see how Pabau validates ICD-10-CM codes and routes clean claims for orthopedic practices.

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