ICD code S82.244F – Nondisplaced spiral fracture of the right tibial shaft

Key takeaways

S82.244F covers a routine-healing follow-up for a nondisplaced spiral fracture of the right tibial shaft. It applies only for an open fracture type IIIA, IIIB, or IIIC.

ICD-10-CM guidelines Section I.C.19.c define F as subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing. Using A at a follow-up visit is a common audit trigger.

Delayed healing of the same open fracture takes S82.244J, while a closed fracture healing routinely takes S82.244D.

Displacement status and laterality must both be documented explicitly. A note that omits either forces a less specific, denial-prone code.

Pabau’s claims management software automates ICD-10 code validation and clean-claim checks before submission, reducing S82.244F denials at orthopedic and sports medicine practices.

ICD-10 Code S82.244F: Quick reference

ICD-10 Code S82.244F covers a follow-up visit for a nondisplaced spiral fracture of the right tibial shaft that is healing routinely.

The original fracture must have been open type IIIA, IIIB, or IIIC. The code is billable and valid for the 2026 fiscal year, and the table below gives coders a quick check before they submit a claim.

What S82.244F means: Breaking down the code

Each character in S82.244F carries a distinct clinical meaning. Misreading any one segment leads to the wrong code.

The spiral pattern reflects a rotational mechanism of injury, typically a twisting force. On radiographs, the fracture line winds around the tibial shaft in a helical pattern. If the clinical note says “oblique” while imaging describes a spiral line, query the provider before choosing between S82.23- and S82.24-. The pattern carries forward to every follow-up claim.

Understanding the 7th character ‘F’: subsequent encounter with routine healing

The 7th character in ICD-10-CM fracture codes sets the encounter type, the open or closed status, and the healing stage. Selecting the wrong one is a common source of claim denials and audit flags on tibial shaft fracture claims.

What “subsequent encounter” means: Under ICD-10-CM Official Guidelines Section I.C.19, a subsequent encounter comes after the patient has completed active treatment of the fracture. The patient is now receiving routine care during the healing or recovery phase. Typical examples are a cast change or removal, an X-ray to check healing, removal of a fixation device, and other follow-up visits. These visits don’t have to be with the original treating provider.

What “routine healing” means: Routine healing means the fracture is progressing as clinically expected, with no complications. A note that says “healing well” or “fracture looks good” isn’t always enough on its own. The clinician’s assessment has to support normal, uncomplicated healing. Callus formation in the expected timeframe with maintained alignment supports it. If the note is ambiguous, the coder can’t infer routine healing.

Full S82.244 7th-character table

Critical clarification on S82.244F vs S82.244D: S82.244D is the code for a closed fracture, subsequent encounter, routine healing. S82.244F applies when the fracture was open type IIIA, IIIB, or IIIC at the time of injury. The F suffix does not mean “follow-up for any spiral tibia fracture.” It is tied to the open fracture type at initial treatment, so confirm the original injury documentation before selecting F over D.

The grid below reduces every follow-up character to two questions: what the fracture was at injury, and how it is healing now.

S82.244F vs adjacent codes: How to choose correctly

The codes most often confused with S82.244F differ on four axes: displacement, laterality, open or closed status, and healing stage. A single wrong character changes the clinical meaning entirely.

The confusion that matters most is between S82.244F and S82.244J. Both describe a follow-up for the same open type IIIA, IIIB, or IIIC fracture, and only the healing trajectory differs. J applies when the note documents slow callus formation or persistent pain at the fracture site, so selecting F there undercodes the case. When the original fracture was closed, the choice moves to S82.244D for routine healing or S82.244G for delayed healing.

Clinical scenarios: When to use S82.244F

S82.244F is correct only when all four of these conditions are met:

• The fracture is a nondisplaced spiral pattern on the right tibial shaft.
• The injury was classified as open type IIIA, IIIB, or IIIC at initial treatment.
• The patient is at a follow-up after active treatment, not the first treatment visit.
• Healing is progressing normally.

Practices with high-volume orthopedic or sports medicine caseloads see this code regularly in post-surgical follow-up visits. Examples where S82.244F applies:

• Week-6 follow-up after debridement and fixation of an open Gustilo IIIA fracture. Imaging confirms maintained alignment, and the attending note documents “fracture healing well, callus visible.”
• Orthopedic surgeon’s follow-up for a patient first treated in the ED for an open tibial shaft fracture (Gustilo type IIIA). The patient now presents for wound inspection and X-ray review.
• Physical therapy practice billing a rehabilitation evaluation that references the active fracture diagnosis. The PT note must still document fracture status, and the original open IIIA, IIIB, or IIIC classification must be on record.

Examples where S82.244F does NOT apply, and the correct alternative:

• First visit, where the fracture is diagnosed and treated: use S82.244A for a closed fracture. Open fractures take S82.244B (type I or II) or S82.244C (type IIIA, IIIB, or IIIC).
• The original fracture was closed and is healing routinely: use S82.244D.
• Follow-up for an open type IIIA, IIIB, or IIIC fracture where the surgeon notes inadequate callus at 10 weeks: switch to S82.244J (delayed healing). For a closed fracture, the delayed-healing code is S82.244G.
• Imaging confirms nonunion of an original open type IIIA, IIIB, or IIIC fracture: code S82.244N. A closed fracture nonunion takes S82.244K.
• The fracture has healed and the patient presents with a late effect, such as chronic ankle stiffness: use S82.244S (sequela).

Documentation requirements to support S82.244F

Every element of the code must be traceable to the clinical record. Missing a single axis forces a less specific code, increases denial risk, and creates an audit vulnerability.

• Laterality — right tibia: The note must state “right” explicitly. “The tibia” or “the affected limb” is insufficient. Imaging reports that reference the correct side are acceptable supporting documentation but do not substitute for the clinical note.
• Fracture site — shaft/diaphysis: “Tibial shaft fracture” or “diaphyseal fracture of the tibia” is required. “Leg fracture” or “lower extremity fracture” maps to a non-specific code.
• Fracture pattern — spiral: The treating physician’s original note or operative report must describe the fracture as spiral or helical. Radiology reports using this language are acceptable.
• Displacement status — nondisplaced: The note must document bone fragment alignment. “No displacement,” “fragments remain in anatomic position,” or equivalent language in either the clinical note or imaging report satisfies this requirement.
• Open fracture type — Gustilo IIIA, IIIB, or IIIC: The record must state that the fracture was open and name its Gustilo type. Closed fractures use S82.244D.
• Encounter type — subsequent/follow-up: The visit documentation should show the patient is returning for routine care after active treatment, not presenting for the first time. This is usually clear from context (e.g., “Patient returns for 6-week follow-up”), but it must be inferable from the record.
• Healing status — routine: This is the most frequently underdocumented element. A note that says “doing well” without reference to fracture alignment, callus formation, or healing assessment does not reliably support “routine healing.” A brief objective statement such as “X-ray shows progressive callus formation, alignment maintained” gives the coder the evidence the code needs.

CPT code pairings for S82.244F encounters

ICD-10 Code S82.244F appears as the diagnosis code alongside procedure codes that describe the service rendered at the follow-up encounter. The pairing must reflect what happened at the visit. Pairing S82.244F with an initial-treatment CPT code at a follow-up visit is a medical necessity mismatch that payers deny.

Visits inside the global period after fixation are reported with 99024, which carries no separate fee. Healing films taken at those visits fall outside the surgical package and are usually coded as 73590, with S82.244F as the supporting diagnosis.

Payer requirements and common claim denial reasons for ICD-10 Code S82.244F

Medicare follows the ICD-10-CM Official Guidelines for encounter-type documentation. CMS does not publish a specific LCD for routine tibial shaft fracture follow-up. Local Coverage Determinations for orthotics and imaging paired with S82.244F may still apply, depending on the service billed. Commercial payers mirror CMS encounter-type rules in most cases, though prior authorization rules for advanced imaging or surgery vary by plan year.

The table below covers the most common denial patterns for S82.244F claims and the recommended resolution for each.

Proactive denial management cuts rework on tibial shaft fracture claims. Checking eligibility and clean claim requirements before the appointment means fewer of those claims come back for rebilling.

Excludes notes and coding hierarchy for S82.244F

S82.244F is valid only for traumatic fractures. The ICD-10-CM tabular list places Excludes1 and Excludes2 notes at the S82 category level. They decide which diagnoses can sit alongside codes in this category.

Excludes1 at S82 (never coded together)

• Traumatic amputation of lower leg: use S88.- instead

Excludes2 at S82 (can be coded together)

• Fracture of foot, except ankle (S92.-)
• Periprosthetic fracture around internal prosthetic ankle joint (M97.2)
• Periprosthetic fracture around internal prosthetic knee joint (M97.1-)

Pathological fractures sit outside S82 altogether. Use M84.5- for a fracture caused by neoplastic disease, M84.4- for other pathological fractures, and M80.- for osteoporosis with a current pathological fracture. Stress fractures of the tibia take M84.36- codes.

ICD-10-CM hierarchy: S82 to S82.244F

• S00-T88 — Injury, poisoning and certain other consequences of external causes (chapter)
• S82 — Fracture of lower leg, including ankle
• S82.2 — Fracture of shaft of tibia
• S82.24 — Spiral fracture of shaft of tibia
• S82.244 — Nondisplaced spiral fracture of shaft of right tibia
• S82.244F — Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

The CDC/NCHS ICD-10-CM web tool and the CMS ICD-10 codes page both publish the annual tabular list with full Excludes notes for S82. Always verify against the current fiscal year release before submitting, as effective dates and Excludes language can change with each annual update. The AAPC ICD-10-CM lookup and ICD List provide searchable interfaces against the same official data.

The other S82 code pages on this site sit in our ICD-10-CM codes archive, which helps when the documentation points to a neighboring code.

How claims management software prevents S82.244F denials

A follow-up claim for S82.244F depends on three records agreeing. The initial ED or operative note carries the Gustilo type, the visit note carries the healing assessment, and the imaging report confirms laterality. When they disagree, the error usually surfaces weeks later as a denial.

Pabau, the practice management platform we build, moves that check to the pre-billing stage. Its claims management software validates CPT-to-ICD-10 pairings before submission, so pairing mismatches are caught before the payer sees them. Pabau also integrates with the Claim.MD clearinghouse, which checks diagnoses and procedures against payer rules before the 837P reaches the insurer.

The result is fewer claims bounced for a wrong 7th character or a mismatched procedure code. Your billing team spends less time on rework and more time on claims that are still in flight.

Reduce tibial fracture claim denials before they happen

Pabau integrates with Claim.MD to validate ICD-10 and CPT pairings, check eligibility, and flag missing documentation before your claim reaches the payer. Orthopedic and sports medicine practices use Pabau to cut denial rework and speed up revenue collection.

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Conclusion

S82.244F is only as defensible as the initial-encounter record behind it. Before coding any follow-up on this fracture, pull the original ED or operative note. Confirm it says open, with a Gustilo type of IIIA, IIIB, or IIIC. If it doesn’t, the code is S82.244D or S82.244E, however well the wound is healing.

The healing assessment decides the rest. Callus and maintained alignment support F, while slow callus formation moves the claim to S82.244J, and a coder should never have to guess between them.

Adding both facts to the follow-up note template costs two fields and removes the most common reasons these claims come back. Book a demo to see how Pabau checks S82.244F follow-up claims against payer rules before they go out.

Continue your research

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