ICD-10 code S82.465C: Nondisplaced segmental left fibula fracture

Key takeaways

ICD-10 code S82.465C describes a nondisplaced segmental fracture of the shaft of the left fibula, initial encounter for open fracture type IIIA, IIIB, or IIIC

In the S82.46 subcategory the 6th character encodes displacement and laterality together, so the 5 in S82.465 means nondisplaced and left

The laterality alternates are S82.464C for the right leg and S82.466C for an unspecified leg, not S82.461C or S82.462C

The 7th character C designates an open fracture with severe soft tissue injury or arterial damage

Practice management software like Pabau integrates with Claim.MD to validate and submit fracture diagnosis codes across thousands of US payers

ICD-10 code S82.465C is the billable code for a nondisplaced segmental fracture of the shaft of the left fibula. It applies at the initial encounter for an open fracture graded Gustilo-Anderson type IIIA, IIIB, or IIIC. The code is also laterality-specific, which catches coders who read the 6th character as a laterality digit on its own.

This code is valid and billable for fiscal year 2026. It falls within the S82 category, which covers fractures of the lower leg, including the ankle. CMS and the National Center for Health Statistics maintain that category jointly, under the ICD-10-CM Official Guidelines for Coding and Reporting.

ICD-10 code S82.465C: Quick reference

Per the CDC/NCHS ICD-10-CM web tool, this code is confirmed as a valid, specific code for fiscal year 2026. Coders working in sports medicine and orthopedic settings meet it in trauma and acute care contexts.

Full description of a nondisplaced segmental fracture of the left fibula

Each component of the code description carries a specific coding meaning. Misreading any one element leads to a code assignment error.

• Nondisplaced: The fracture fragments stay in anatomical alignment. The displaced version of the same fracture on the same side is S82.462C, which sits in the displaced half of the S82.46 subcategory.
• Segmental: The fibula shaft has two fracture lines, creating an isolated bone segment between them. This pattern differs from a simple transverse, spiral, or oblique fracture, and it reflects greater energy transfer to the bone.
• Shaft of fibula: The fracture involves the diaphysis, or mid-portion, of the fibula rather than the proximal or distal ends. This places it within the S82.4 subcategory.
• Left fibula: The record documents the left leg. When the right leg is documented, assign S82.464C. Reserve S82.466C for records that genuinely do not state the side.
• Initial encounter (7th character C): The patient is receiving active treatment for the fracture at this visit. The character C also specifies an open fracture classified as Gustilo-Anderson type IIIA, IIIB, or IIIC.

Read together, these components point to one code and one side. A segmental fibula fracture that is displaced, on the right leg, or at a later encounter takes a different code entirely. Coders in physical therapy EMR workflows also see this code on referral documentation when patients transition from acute care to rehabilitation.

Laterality: How the 6th character works in S82.46

The 6th character in the S82.46 subcategory does double duty. It encodes displacement and laterality at the same time, rather than laterality alone. Characters 1 through 3 cover displaced fractures, and characters 4 through 6 cover nondisplaced fractures.

That is why S82.465 reads as nondisplaced and left. The 5 is the second digit in the nondisplaced run, and the second position in each run is the left leg. The grid below shows both runs side by side.

So S82.461C and S82.462C are not laterality alternates for S82.465C. Both describe a displaced segmental fracture, which is a different fracture pattern. Substituting one for the other changes the injury reported on the claim, not just the side.

The parent code S82.46 is titled segmental fracture of shaft of fibula. It covers displaced and nondisplaced variants alike, so the subcategory title on its own settles neither displacement nor side.

The 7th character variants of S82.465

The 7th character is the most consequential coding decision for the S82.465 code family. It specifies the encounter type and, for open fractures, the wound severity grade. Character C is among the hardest to assign, because it depends on the physician documenting the Gustilo-Anderson classification in the record.

S82.465 takes all 16 valid fracture 7th characters. The table below lists every one of them against the left-fibula base code.

The ICD-10-CM Official Guidelines add an important clarification. Initial encounter is determined by whether the patient is receiving active treatment for the fracture. It does not depend on whether a provider is seeing the patient for the first time. A surgeon performing operative fixation at a second hospital visit is still providing active treatment.

Coders can verify the full child-code tree with the AAPC Codify ICD-10-CM lookup. The right-leg and unspecified-leg codes follow the same 7th character structure, so S82.464C and S82.466C exist alongside S82.465C.

Gustilo-Anderson classification: Open fracture types IIIA, IIIB, and IIIC

The Gustilo-Anderson classification is the standard framework for grading open fractures by wound severity and soft tissue damage. Only the attending physician can determine and document the type. Coders assign ICD-10 code S82.465C from that documented classification, never from their own clinical interpretation.

All three subtypes map to the same 7th character C in ICD-10-CM. The coding system does not separate them at the code level, so the clinical distinction lives in the surgical and nursing documentation instead. Practices coding high-acuity trauma diagnoses alongside vascular injury codes will see all three subtypes within a single inpatient episode.

Parent code hierarchy and navigation

Knowing where S82.465C sits in the ICD-10-CM hierarchy helps coders confirm they are at the correct specificity level. It also shows which code blocks cover adjacent injury types.

• 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
• S82.4: Fracture of shaft of fibula
• S82.46: Segmental fracture of shaft of fibula, covering both displaced and nondisplaced variants
• S82.465: Nondisplaced segmental fracture of shaft of left fibula
• S82.465C: [+ 7th character C] Initial encounter for open fracture type IIIA, IIIB, or IIIC

Note that S82.4 covers fractures of the fibula shaft specifically. Proximal fibula fractures near the knee are coded elsewhere in the S82 block. For distal fibula fractures involving the ankle, review the S82.6x series before assigning. This kind of hierarchy reading is the same habit that makes procedure code families easier to navigate.

MS-DRG mapping and reimbursement for S82.465C

For inpatient claims, ICD-10 code S82.465C triggers specific MS-DRG assignments through the CMS grouper. This code represents a high-severity open fracture, so the DRG assignment reflects the resource intensity of Gustilo type III injuries. That includes potential vascular repair, wound coverage procedures, and extended stays.

Practices submitting inpatient claims can use electronic claims via Claim.MD, our US clearinghouse partner. Claim.MD validates ICD-10-CM codes against current CMS grouper logic before submission across thousands of US payers. Understanding revenue cycle management matters here, because MS-DRG weights drive the base reimbursement the facility receives.

Key reimbursement considerations for this code:

• DRG weight reflects complexity: Open fractures with type III wounds typically group to higher-weight DRGs than closed fractures, reflecting greater OR time and inpatient resources.
• Secondary codes matter: Vascular injury codes for type IIIC, wound coverage procedure codes, and external cause codes all influence the final DRG assignment. Report each one that the record documents.
• Present on admission indicator: This code is typically POA = Yes for trauma admissions. Accurate POA reporting affects hospital-acquired condition penalties.
• Verify current DRG assignments: CMS updates DRG weights and assignments annually. Check the CMS fee schedule and payment files for the current fiscal year before finalizing reimbursement estimates.

Practices managing fracture billing can also review medical clearinghouse submission processes, so ICD-10 codes are validated before they reach the payer. That reduces the grouper errors that lead to underpayment.

Coding guidelines and documentation requirements

The ICD-10-CM Official Guidelines for Coding and Reporting set specific fracture coding rules that shape S82.465C assignment. Meeting the documentation thresholds prevents downcoding, supports medical billing compliance, and keeps the 7th character defensible on audit.

• The physician must document the Gustilo-Anderson type. Coders cannot infer the type from operative notes or wound descriptions alone. The treating physician has to record Gustilo type IIIA, IIIB, or IIIC, or equivalent language, for the 7th character C to hold.
• Match the code to the documented side. S82.465C is the left-fibula code. If the operative report, imaging report, or physician note documents the right leg, assign S82.464C. Use S82.466C only when the record genuinely does not state the side.
• Confirm displacement separately from side. The 6th character carries both, so a note reading left segmental fibula fracture is not enough on its own. The record has to say whether the fracture is displaced or nondisplaced.
• Encounter type follows the nature of the visit, not chronology. A patient returning for wound care on day three is still in active treatment if the fracture is being managed. Active treatment covers operative procedures, external fixation adjustments, and wound irrigation.
• Open fracture documentation requirements. For the open fracture 7th characters B and C, the record must document an open wound communicating with the fracture. A soft tissue injury next to a fracture does not make it an open fracture.
• Additional code for wound or vascular injury. Type IIIB and IIIC fractures usually need additional codes for the soft tissue defect or arterial injury. Review the sequencing guidelines when several injury codes apply.

Check whether a superbill carries the ICD-10 code in full or relies on shorthand. Incomplete code entry at the point of care is a common source of 7th character and laterality errors. Claims management software with a built-in ICD-10 catalogue flags truncated codes before submission.

CPT codes commonly billed with S82.465C

S82.465C is a diagnosis code, so it never travels alone on a claim. It supports the procedure codes billed for the same episode of care. The table below lists CPT codes that commonly accompany an open segmental fibula shaft fracture.

CPT is maintained by the American Medical Association, and the code billed has to match the procedure the surgeon documented. Type IIIB fractures often add a flap or graft code for soft tissue coverage. Treat this table as a starting point for the chart review, not a substitute for it.

Common coding errors to avoid with S82.465C

Open fracture codes in the S82 series generate a disproportionate share of orthopedic coding denials. These are the errors seen most often with this specific code.

• Reading S82.465C as an unspecified-leg code. It is the left-fibula code. The unspecified-leg equivalent is S82.466C, and assigning S82.465C to a record that omits the side reports a side the physician never documented.
• Treating S82.461C and S82.462C as the laterality alternates. Both sit in the displaced segmental family, so they change the fracture pattern rather than the side. The correct alternates are S82.464C for the right leg and S82.466C for an unspecified leg.
• Using 7th character B where C applies. Character B covers open fracture types I and II, while character C covers the type III grades. Choosing B for a documented type IIIA fracture undercodes the severity. A DRG-based payer will then regroup the claim to a lower weight.
• Assigning a subsequent-encounter character during active treatment. Coders sometimes reach for D or F because the patient has been seen before, but the rule is encounter type, not visit count. A surgical debridement during active fracture management is an initial encounter.
• Missing secondary codes for vascular injury in type IIIC. When the physician documents arterial injury requiring repair, the specific arterial injury code is also required. Omitting it can trigger a medical necessity query on the inpatient claim.
• Failing to verify the code against the date of service. ICD-10-CM is updated every October. Confirm S82.465C was valid for the date of service, especially when coding retroactively. Practices can work active cases through a structured claim denial workflow.

Practices billing through a clearinghouse catch some of these at the claim validation stage. Reviewing electronic remittance advice for diagnosis-related adjustment reason codes helps coders spot patterns across several fracture claims at once.

Where to verify S82.465C

ICD-10-CM changes every October, so check the code against the fiscal year of the date of service. These four sources settle almost every question about this code.

• CDC/NCHS ICD-10-CM web tool: The official tabular list and alphabetic index, free to search, showing the full S82.46 tree with laterality and displacement.
• CMS ICD-10 code files: The annual code descriptor files and addenda, which show what was added, deleted, or revised for the fiscal year.
• ICD-10-CM Official Guidelines for Coding and Reporting: The chapter 19 fracture rules, including the 7th character instructions and the laterality guidance.
• AAPC Codify: A commercial lookup that lists every child code under S82.46 side by side, which makes displacement and laterality easy to compare.

When two sources disagree, the CDC/NCHS tabular listing is the one that governs. Note the fiscal year you checked in the coding note, so an auditor can retrace the decision later.

How Pabau keeps fracture laterality attached to the claim

In many orthopedic practices the fracture detail lives in one system and the claim is built in another. A coder reads the operative note, picks the 7th character, then retypes the code into a billing screen. Those two details are the ones that get dropped in that handoff.

Practice management software like Pabau keeps the two together. The diagnosis code sits on the appointment record, beside the clinical note that supports it. The claim is then built from that record rather than retyped. Pabau also integrates with Claim.MD, so codes are validated before submission across thousands of US payers.

The result is fewer denials on codes that were correct in the chart and wrong on the claim. Coders keep an audit trail as well, so a 7th character or a laterality digit can be defended months later without reopening the paper record.

Streamline fracture billing with Pabau

Pabau integrates with Claim.MD to submit and track ICD-10 coded claims across thousands of US payers. Validate laterality and 7th characters before submission, manage denials, and track electronic remittance in one platform.

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Conclusion

Accurate assignment of ICD-10 code S82.465C rests on three details the medical record has to supply. It needs confirmation of the open fracture, the physician’s documented Gustilo-Anderson type, and the left-side laterality. Without all three, coders face either a specificity error or a 7th character they cannot defend on audit.

Keep the 6th character in mind above all. The 5 in S82.465 carries displacement as well as side, which makes S82.464C the right-leg alternate and S82.466C the unspecified-leg alternate. S82.461C and S82.462C belong to the displaced segmental family instead.

Pabau’s claims management software validates ICD-10-CM codes through Claim.MD before they reach the payer, flagging truncated codes and grouper mismatches at submission. Book a demo to see how Pabau handles orthopedic and trauma billing workflows end to end.

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