ICD code S82.142D – Displaced bicondylar left tibia fracture

Key takeaways

S82.142D is the billable ICD-10-CM code for a displaced bicondylar fracture of the left tibia at a routine-healing follow-up visit.

The 7th character D applies after active treatment is completed, during routine care such as cast changes, healing X-rays and medication adjustments.

Reporting S82.142A at a follow-up visit instead of S82.142D is a frequent coding error, because A signals active treatment.

Side, both condyles, displacement, closure and healing status all need to be clear in the note before the code is assigned.

When the side is not documented, S82.143D is the unspecified fallback, but a physician query should come first.

ICD-10 code S82.142D covers a left bicondylar fracture in routine healing

ICD-10 code S82.142D is the billable ICD-10-CM code for a displaced bicondylar fracture of the left tibia, at a subsequent encounter with routine healing. In practice, that means a follow-up visit after surgery or casting, when the fracture is mending as expected.

The code narrows in steps. S82 covers fractures of the lower leg, S82.1 the upper end of the tibia, and S82.14 bicondylar fractures. S82.142 adds the left side, and the 7th character D marks routine healing. The code is active in the FY2025, FY2026 and FY2027 ICD-10-CM releases.

Both condyles and the left side have to be documented

A bicondylar fracture breaks both the medial and lateral condyles of the proximal tibia. That is the flared top of the bone, which forms the lower half of the knee joint. Displaced means the fragments have shifted out of alignment. A nondisplaced break, with alignment preserved, codes to S82.145x instead.

These injuries usually follow high-energy trauma, such as a car crash or a fall from height. Patients tend to arrive with joint-line tenderness, heavy swelling and an inability to bear weight.

Laterality is mandatory in ICD-10-CM. S82.142x codes apply to the left tibia only, and right-side fractures use S82.141x. An unspecified-side displaced bicondylar fracture uses S82.143x (displaced bicondylar fracture of unspecified tibia). That fallback should prompt a coder query first. You can compare every sibling in our ICD-10-CM reference for coders.

Closure status matters too. S82.142D assumes a closed fracture. Open fractures take their own 7th characters, based on the Gustilo classification.

• S82.142B: initial encounter, open fracture type I or II
• S82.142C: initial encounter, open fracture type IIIA, IIIB, or IIIC
• S82.142E/F: subsequent encounter variants for open type I/II and IIIA-IIIC with routine healing

The 7th character D means routine healing after active treatment

The 7th character D means routine care during the healing or recovery phase, after active treatment is completed. ICD-10-CM Official Guidelines Section I.C.19.a gives examples such as cast changes or removal, X-rays to check healing, and medication adjustments. Other aftercare and follow-up visits after treatment of the injury qualify too.

Here is where D sits among the other 7th characters for S82.142x.

Delayed healing, nonunion and malunion are clinical calls. A coder can’t infer them from the notes, so each needs explicit physician documentation before G, K or P is assigned.

One wrong detail moves the claim to a sibling code

S82.142D sits in a crowded sibling group. A wrong pick typically comes down to encounter type, laterality or displacement. The decision path below runs the checks in the order a coder reads the note.

The table lists the same siblings, with the mistake that usually lands a claim on each one.

A worked example: the six-week check

A patient had open reduction and internal fixation for a left bicondylar plateau fracture six weeks ago. Today’s note reads: “Left tibia, both condyles, displaced, closed. Callus on X-ray, healing as expected. Weight-bearing advanced.”

All six checks pass, so the visit codes to S82.142D. The surgeon’s operative claim carried S82.142A. Had the note said “healing slower than expected,” the code would move to S82.142G instead.

Six documentation checks support S82.142D

Six elements need to be clear in the note before a coder assigns S82.142D. A missing one either triggers a query or forces a less specific code.

1. Laterality: the note states “left” tibia or left lower extremity. “Bilateral” alone does not support S82.142D.
2. Fracture type: the note says “bicondylar” or describes both the medial and lateral condyles. “Tibial plateau fracture” maps to bicondylar only when both condyles are confirmed. A unicondylar plateau fracture uses a different code.
3. Displacement status: the note says “displaced” or “nondisplaced.” If it says neither, ICD-10-CM defaults to displaced. Check that no other part of the record calls the break nondisplaced.
4. Encounter stage: active treatment is complete. The visit is a follow-up, a post-operative check or routine aftercare, not the encounter where definitive treatment happens.
5. Healing status: no documented delayed healing, nonunion or malunion. Any of the three rules out D.
6. Fracture closure: the fracture is documented as closed, or closure isn’t stated, which defaults to closed. A documented open fracture moves the code to S82.142E or S82.142F.

Follow-up CPT codes that pair with S82.142D

Because S82.142D marks a subsequent encounter, its CPT partners are follow-up and management services. The operative codes, 27535 and 27536 for open treatment of tibial plateau fractures, go with S82.142A on the surgical claim.

Check the global period before billing a visit. The surgeon’s routine post-op visits fall inside the 90-day global package and aren’t billed separately. Medicare pays diagnostic X-rays outside that package, but commercial rules vary, so confirm the contract.

NCCI edits also update quarterly. Confirm the active version before you bill imaging alongside an office visit.

Payer rules for S82.142D vary by program

Payer rules for S82.142D change by program and service type, and they change every year. Use the points below as a starting map, then confirm against the current plan policy.

• Medicare: standard office follow-ups billed with S82.142D need no prior authorization. The note still has to show the visit is medically necessary for fracture management, not routine wellness care.
• Medicaid: requirements vary by state. Some states require a referral for orthopedic follow-up, while others allow direct billing.
• Commercial payers: many require a referral or prior authorization once specialist visits pass a set number. Physical therapy usually needs a treatment plan on file, and authorization often applies after a set number of visits.
• Code-service alignment: a D code paired with an initial-treatment CPT, such as an operative reduction code, contradicts itself and triggers an edit.
• Telehealth: coverage for fracture follow-up by telehealth varies by payer. Check each payer’s current policy before billing a virtual visit with S82.142D.

Run a real-time eligibility check through your clearinghouse ahead of each visit, confirming active coverage before the patient arrives. A lapsed plan is far easier to fix at check-in than after a denial lands.

Six denial patterns to catch before you submit

The same denial patterns keep returning on this code. Each one has a documentation or submission fix.

1. Wrong 7th character: reporting S82.142A at a follow-up visit instead of S82.142D is a frequent coding error. The A character signals active treatment, so it clashes with a routine cast check or healing X-ray.
2. Missing laterality: using the unspecified S82.143D instead of the left-specific S82.142D. Payers can reject unspecified laterality when the record supports a specific side.
3. Code-procedure mismatch: pairing D with an initial-treatment procedure, such as an open reduction CPT, creates an encounter-type conflict.
4. Complication not coded: the note documents delayed healing, but the claim carries the D character. It should carry G, and some payers deny continued care as not medically necessary.
5. Thin medical necessity: a note that records vitals and range of motion, with no treatment plan, doesn’t support continued follow-up billing.
6. Global period overlap: billing the surgeon’s routine post-op visit as an E/M during the 90-day global period. Those visits are included in the surgical fee, and some payers want them reported with 99024.

Tracking the CARC on each denial shows which pattern keeps recurring. A structured denial management process then fixes the cause upstream, so the same claim isn’t resubmitted again and again.

Instructional notes that change how S82.142D is reported

The S82 category carries instructional notes that decide which codes can sit beside S82.142D. Reading them first prevents both undercoding and coding conflicts.

Excludes1 note at S82: traumatic amputation of the lower leg (S88.-) is an Excludes1 exclusion. S82 and S88 codes can’t be reported together, so if an amputation occurred, only the amputation code applies.

Excludes2 notes at S82: fracture of foot (S92.-) and periprosthetic fracture around an internal prosthetic implant of the knee (M97.-) are Excludes2 exclusions. These conditions can coexist with a tibial fracture and be coded together when both are documented.

“Code also” for open wounds: if an associated open wound is present, the tabular instructs the coder to add a code for the wound. That holds at subsequent encounters while the wound is still being managed.

Fibula fractures: S82.142D covers the tibia only. A documented fibula fracture needs its own code, for example from S82.4x (fibula shaft) or S82.6x (lateral malleolus). Don’t assume the tibia code captures both bones.

For the full tabular list and its notes, use the CDC’s ICD-10-CM web tool. The AAPC Codify ICD-10-CM lookup adds clinical crosswalk context for harder scenarios.

CMS’s ICD-10 codes page carries the annual update files and coding guidelines. The ResDAC ICD codes resource shows how these codes appear in Medicare claims data, which helps with compliance audits.

How an S82.142D claim moves from note to payment

Clean S82.142D claims depend on consistent 7th characters across the whole episode. Each follow-up claim should read logically next to the earlier A-character claim in the patient record.

1. Re-check eligibility. Fracture episodes often run 8 to 16 weeks, and coverage can change in that time. Repeat insurance eligibility verification before each follow-up, not just the first visit.
2. Code the visit. Assign S82.142D from the note, then add the CPT codes for the services performed.
3. Send the 837P. The 837 electronic claim carries the diagnosis, procedure and place-of-service codes to the payer. Clearinghouse edits reject invalid codes, such as S82.142 sent without its 7th character.
4. Read the remittance. The 835 electronic remittance advice returns the payer’s CARC codes on any denial. Sorting by CARC shows whether the cause is the 7th character, laterality or medical necessity.

Before you submit: A quick checklist

• The note names the left tibia and both condyles.
• Displacement and closure are stated, or the defaults genuinely apply.
• Active treatment is complete, and healing is routine.
• The CPT codes describe follow-up services, not initial treatment.
• The visit falls outside the surgeon’s global period, or is reported as included.
• Eligibility was re-checked for this visit.

How Pabau keeps fracture follow-up claims moving

A fracture episode means the same admin at every visit. Staff re-key the diagnosis, re-check coverage and chase each remittance by hand.

Pabau, the practice management and billing platform we build, pre-fills each claim from the patient record. The diagnosis already on the problem list lands on the claim form. Its claims software for practices checks required fields before sending. It also runs eligibility checks, ERA posting and claim tracking through Claim.MD.

Choosing the 7th character stays a coding decision, made from the note. The time around it shrinks, with fewer manual steps per visit and denials that are easier to trace.

Spend less time reworking fracture follow-up claims

Pabau pre-fills claims from the patient record, checks required claim fields and runs Claim.MD eligibility checks before submission. Your team spends less time rekeying and chasing follow-up visits.

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Conclusion

S82.142D is narrow by design. It fits a left bicondylar tibial fracture that is past active treatment and healing on schedule.

The habit worth keeping is simple: re-check the 7th character at every visit of the episode. The note changes as healing progresses, and the code has to follow it.

For practices with a steady flow of orthopedic follow-ups, software can take the repeat work off each claim. Pabau’s claims management software pre-fills claims from the record and provides ICD-10-CM and CPT code lookup. It also checks required claim fields and runs eligibility checks via Claim.MD before submission.

Book a demo to see how it handles your fracture follow-up billing.

Continue your research

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Curious what happens between submission and payment? What is a medical claims clearinghouse covers how claims are checked and routed to payers.

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