ICD-10 Code S82.876D: Nondisplaced pilon fracture of unspecified tibia

Key Takeaways

S82.876D describes a nondisplaced pilon fracture of the unspecified tibia at a subsequent encounter for a closed fracture with routine healing. It is billable and valid for fiscal year 2026.

A pilon fracture breaks the tibial plafond, the weight-bearing articular surface at the bottom of the tibia. S82.87 is a tibia subcategory, not a fibula one.

The sixth character carries displacement and laterality together. Character 6 means nondisplaced with the side unstated, so document left or right and use S82.875D or S82.874D wherever the record allows.

ICD-10-CM excludes pilon fracture from S82.3, S82.5 and S82.6. Bimalleolar, trimalleolar and Maisonneuve fractures sit in S82.84, S82.85 and S82.86.

Pabau integrates with Claim.MD so practices can submit ICD-10 coded claims electronically to 4,000+ US payers and track them through to remittance.

ICD-10 Code S82.876D: definition and clinical description

ICD-10 Code S82.876D is a billable diagnosis code for a nondisplaced pilon fracture of the unspecified tibia, subsequent encounter for closed fracture with routine healing. Coders and clinicians apply it at follow-up visits after a pilon fracture of the distal tibia, once the fracture is closed and healing on schedule.

The code is current for fiscal year 2026 and took effect on October 1, 2025. The CDC/NCHS ICD-10-CM web tool lists it as billable and specific, so it can go on a claim with no more detailed code beneath it. S82.876D has been in the code set since the first non-draft edition in fiscal year 2016, and it has not been revised since.

One detail deserves attention before you assign it. The sixth character 6 means the record never says which tibia was fractured. Payers increasingly question unspecified laterality on an extremity injury. Confirm the side in the note and code S82.875D or S82.874D whenever the documentation supports it.

Code description and clinical meaning

The pilon, also called the tibial plafond, is the ceiling of the ankle joint. It is the weight-bearing articular surface at the lower end of the tibia, sitting directly on top of the talus. Pilon is the French word for pestle, a reference to the way the talus is driven up into the tibia during the injury.

Pilon fractures typically follow a high-energy axial load, such as a fall from height or a motor vehicle collision. The fracture line crosses the joint surface, which makes this an intra-articular ankle injury. That is what separates it from a distal tibia fracture that spares the plafond. It is also why ICD-10-CM gives pilon fractures their own subcategory at S82.87.

Nondisplaced means the fragments stayed in anatomic alignment. ICD-10-CM sets a default here that is worth memorizing. A fracture not documented as displaced or nondisplaced is coded to displaced, so S82.876 needs the record to state nondisplaced in so many words.

Closed means the skin over the fracture is intact, with no open wound or surgical exposure at the site. The classification also defaults to closed when the record is silent. Routine healing means the fracture is moving through normal repair, with no documented delayed union, nonunion, malunion or infection.

The fibula plays no part in this code. Distal fibula and malleolar injuries sit in other subcategories, which the related-codes section below sets out. For lower-energy ankle injuries, clinicians often reach for the Ottawa ankle rules to decide on imaging. A high-energy pilon injury is almost always imaged on arrival.

The S82.87 sixth character: displacement and laterality

S82.87 splits into six five-character codes. The sixth character carries two variables at once, so read it in both directions. Characters 1 to 3 are displaced fractures and characters 4 to 6 are nondisplaced. Inside each group, right, left and unspecified run in that order.

None of these six codes is billable on its own. Each one takes a seventh character, which brings the code to a full seven characters with no placeholder X required. Coders working in chiropractic practice software and orthopedic settings see the whole grid over the life of a single injury.

Understanding the 7th character in fracture coding

The seventh character is mandatory throughout S82. It records the encounter type, the open or closed status, and the healing trajectory. A missing or mismatched seventh character is one of the most common reasons a fracture claim is rejected.

S82.876 takes sixteen valid seventh characters, and the table below lists every one of them. Note that ICD-10-CM skips I, L and O to avoid confusion with the digits one and zero.

Character D applies only when three things are true at the same time. The encounter is a follow-up rather than the first active treatment, the fracture is closed, and healing is on track. Change any one of those and the character changes with it.

The open-fracture characters carry an implication worth spelling out. An open pilon fracture at a routine-healing follow-up takes character E or F, depending on the Gustilo type recorded at the initial encounter.

ICD-10 Code S82.876D code hierarchy

S82.876D sits inside a structured code tree. Walking the parent chain confirms you are in the right chapter and subcategory before you commit to a code. According to the CMS ICD-10 codes page, category S82 covers fractures of the lower leg including the ankle.

Three instructional notes sit at the S82 level and govern every code beneath it. A fracture not indicated as displaced or nondisplaced is coded to displaced. A fracture not indicated as open or closed is coded to closed. Open fracture designations follow the Gustilo classification.

Category S82 also includes fracture of the malleolus, and it excludes traumatic amputation of the lower leg, which belongs in S88. Practices working through physical therapy clinic requirements at intake can map their documentation fields straight onto these hierarchy levels.

Related codes and the codes S82.876D is confused with

Two sets of codes matter here. The first is the sibling group inside S82.87, where only the sixth character changes. The second is the set of neighboring subcategories that ICD-10-CM explicitly keeps separate from pilon fracture.

These are the five-character siblings at the same subsequent encounter with routine healing:

• S82.871D – Displaced pilon fracture of right tibia, subsequent encounter for closed fracture with routine healing
• S82.872D – Displaced pilon fracture of left tibia, subsequent encounter for closed fracture with routine healing
• S82.873D – Displaced pilon fracture of unspecified tibia, subsequent encounter for closed fracture with routine healing
• S82.874D – Nondisplaced pilon fracture of right tibia, subsequent encounter for closed fracture with routine healing
• S82.875D – Nondisplaced pilon fracture of left tibia, subsequent encounter for closed fracture with routine healing

The next set is where most miscoding happens. ICD-10-CM carries an Excludes1 note for pilon fracture of the distal tibia under S82.3, S82.5 and S82.6. Those codes and S82.87 can never be reported together for the same fracture.

• S82.3- Fracture of lower end of tibia. Use it for distal tibia fractures that spare the weight-bearing articular surface.
• S82.5- Fracture of medial malleolus. An isolated medial malleolus fracture is not a pilon fracture.
• S82.6- Fracture of lateral malleolus. This is where many distal fibula ankle fractures actually belong, for example S82.65XD for a nondisplaced left lateral malleolus fracture at a routine-healing follow-up.
• S82.83- Other fracture of upper and lower end of fibula. This is the home of genuine other-fracture-of-lower-end-of-fibula coding, such as S82.832D for the left side.
• S82.84- Bimalleolar fracture of lower leg. A separate subcategory, not a pilon subtype.
• S82.85- Trimalleolar fracture of lower leg. Also separate, and also not a pilon subtype.
• S82.86- Maisonneuve fracture. A proximal fibula fracture with syndesmotic disruption, coded on its own axis. S82.866D is a nondisplaced Maisonneuve fracture of the unspecified leg, not a fibula counterpart to S82.876D.

Practices opening a physiotherapy clinic or adding orthopedic aftercare should build this distinction into their code lookup lists. A pilon fracture and a malleolar fracture look similar in casual notes, and they land in different subcategories.

When to use ICD-10 Code S82.876D

Five clinical facts have to line up before you assign this code. Miss any one of them and a different code applies.

• The fracture involves the tibial plafond. A distal tibia fracture that stops short of the weight-bearing articular surface belongs in S82.3, and an isolated malleolar fracture belongs in S82.5 or S82.6.
• The record states the fracture is nondisplaced. Silence on displacement sends the code to S82.873D, the displaced unspecified-tibia option.
• The record does not identify the side. If the note names the left or right tibia, use S82.875D or S82.874D instead. Character 6 is for genuinely unavailable laterality.
• The encounter is a subsequent visit. The initial active-treatment encounter for a closed pilon fracture takes seventh character A, not D.
• The fracture is closed and healing is routine. An open fracture takes E or F at a routine-healing follow-up. Delayed healing takes G, nonunion takes K, and malunion takes P.

The AAPC ICD-10-CM code lookup is a practical way to confirm the full descriptor and scan adjacent codes before a claim goes out.

Common coding errors with S82.876D

The errors below account for most of the corrections auditors make on pilon fracture claims. Each one is easy to catch during a pre-bill review.

• Coding a distal fibula fracture here. S82.87 is a tibia subcategory. A lower-end fibula fracture belongs in S82.6 or S82.83, depending on the documented pattern.
• Treating bimalleolar or trimalleolar fractures as pilon subtypes. They are separate subcategories at S82.84 and S82.85, and ICD-10-CM keeps them apart deliberately.
• Defaulting to the unspecified side. Character 6 is a last resort. Query the surgeon rather than accept a code that weakens the claim.
• Assuming nondisplaced. The classification defaults the other way, so an unstated displacement status makes the fracture displaced.
• Keeping D after the clinical picture changes. Once the note documents delayed union, nonunion or malunion, the seventh character has to move with it.
• Billing a follow-up inside a surgical global period. Routine aftercare following operative fixation is already bundled into the surgical fee.

Clinical terminology that maps to S82.876D

Surgeons and radiologists rarely write the ICD-10-CM descriptor word for word. These are the phrasings that point to S82.876D when the side is not stated in the record.

• Nondisplaced pilon fracture, follow-up visit, closed, healing normally
• Tibial plafond fracture, nondisplaced, subsequent encounter, routine healing
• Nondisplaced intra-articular distal tibia fracture involving the plafond, closed, follow-up
• Pilon fracture aftercare, closed injury, no healing complication documented
• Nondisplaced fracture of the distal tibial articular surface, subsequent encounter

In the alphabetic index, coders reach this family under Fracture, traumatic, then tibia, then lower end. Always confirm displacement, side, encounter type and healing status against the tabular list before settling on the seventh character. The ICD List free lookup tool supports the same navigation and mirrors official CMS and NCHS data.

Billing and reimbursement for ICD-10 Code S82.876D

S82.876D is a diagnosis code, so it carries no relative value units and no payment rate of its own. It supports the visit or procedure code billed alongside it. Subsequent pilon fracture care usually pairs with an evaluation and management code, interval imaging, or therapy services.

Two structural points shape how the code behaves. S82.876D is exempt from present on admission reporting, which is standard for subsequent-encounter injury codes. On the inpatient side, the MS-DRG grouper (version 43.0) assigns it to DRG 559, 560 or 561. Those are the aftercare musculoskeletal system and connective tissue groups, split by complication and comorbidity level.

Global periods matter on this code more than most. Operative fixation of a pilon fracture is reported with 27827 or 27828, and routine follow-up inside the surgical global period is not separately billable. Check the payer global-period assignment before billing a subsequent-encounter visit.

Payer rules on diagnosis-to-procedure pairing vary widely. The claims management software in Pabau tracks claim status and surfaces denial patterns by payer. For recurring rejections, a structured denial management strategy recovers revenue that would otherwise be written off.

Documentation requirements for subsequent encounter claims

Clinical documentation has to support every element built into S82.876D. Auditors read the descriptor as a checklist and look for each qualifier in the note. A line that says follow-up ankle fracture will not carry the code.

Providers working to physiotherapy clinic compliance requirements can structure the follow-up note around the six elements below, which map one to one onto the code.

• Subsequent encounter status. The note must show this is a follow-up for an injury already in active treatment. Wording such as returning for review of a pilon fracture sustained on a given date settles it.
• Site and joint involvement. Name the tibial plafond or the distal tibial articular surface. A note that says distal tibia fracture alone does not distinguish S82.87 from S82.3.
• Displacement status. State nondisplaced explicitly. Without it the code defaults to the displaced sibling.
• Laterality. Record left or right at every visit. Do not rely on an earlier note to carry the side forward.
• Fracture type. Confirm the fracture remains closed. Any wound or surgical exposure at the site changes the seventh character.
• Healing status assessment. This is the most under-documented element. Record radiographic callus, pain and swelling trends, weight-bearing progress, and any change in immobilization.

Our guide to medical billing workflows covers how these documentation thresholds feed into a clean submission. If subsequent-visit claims are already being denied, reviewing what makes a clean claim is a productive first step before appealing.

How Pabau supports fracture claim submission

Fracture aftercare generates a long tail of short visits. Each one needs the right seventh character, the right diagnosis-to-procedure pairing, and a note that backs both up. Most practices manage that across a scheduling tool, a separate notes system, and a billing portal that none of them talk to.

Pabau keeps the whole sequence in one record. Clinicians write the follow-up note against the same chart the appointment came from. The coded claim is then built from what is already in that record. The Claim.MD integration then submits it electronically to 4,000+ US payers in CMS-1500 and 837P formats, with real-time eligibility checks before the visit.

The result is fewer rekeyed claims and a shorter gap between the visit and the remittance. Denials come back into the same dashboard, so a pattern across one payer is visible within days rather than at quarter end. Practices running physical therapy practice management or sports medicine clinic software workflows use the same pipeline for rehabilitation visits.

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Conclusion

S82.876D is a narrow code doing a specific job. It marks a follow-up visit for a closed, nondisplaced pilon fracture of the tibia that is healing as expected, with the side left unstated. Getting it right means checking four things in the note every time. The plafond is involved, the fracture is nondisplaced, the encounter is subsequent, and healing is routine.

The single highest-value habit is chasing down the laterality. Character 6 exists for records that genuinely do not name a side, and most records can name one. Ask the question and code S82.875D or S82.874D instead.

Pabau’s claims management software connects to the Claim.MD clearinghouse. Practices can submit these claims electronically, verify payer eligibility ahead of the visit, and track remittance advice as it lands. To see how it handles ICD-10 billing across orthopedic and rehabilitation settings, book a demo.

Continue your research

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