ICD code S92.122B – Displaced fracture of body of left talus

Key takeaways

ICD-10 Code S92.122B describes a displaced fracture of the body of the left talus, initial encounter for an open fracture. It is billable in FY2026.

The seventh character B means the record documents a wound at the fracture site. Without that wording, the closed-fracture code S92.122A applies instead.

S92.122B is left-talus specific. A displaced body fracture of the right talus takes S92.121B on the initial open encounter.

Practice management software like Pabau validates ICD-10 and CPT pairings before submission, so open-fracture claims stop bouncing back from the payer.

Code hierarchy and classification

S92.122B sits in Chapter 19 of ICD-10-CM, which covers injury, poisoning and certain other consequences of external causes. Each level of the hierarchy narrows the diagnosis by bone, then by side, then by displacement, then by encounter. Reading it downward is the fastest way to land on the right code from a clinical note.

• S00-T88: Injury, Poisoning and Certain Other Consequences of External Causes
• S90-S99: Injuries to the ankle and foot
• S92: Fracture of foot and toe, except ankle
• S92.1: Fracture of talus
• S92.12: Fracture of body of talus
• S92.122: Displaced fracture of body of left talus
• S92.122B: Displaced fracture of body of left talus, initial encounter for open fracture

The National Center for Health Statistics (NCHS) co-maintains ICD-10-CM alongside CMS. Verify the code against the CDC/NCHS ICD-10-CM web tool for the current fiscal year, because descriptions and chapter notes change with the annual update.

What the seventh character “B” means

The seventh character sets the encounter type, and the wrong one is a common reason fracture claims get denied. Chapter 19 applies the same seventh-character conventions across its injury codes, so the logic below transfers to any fracture family.

Seven seventh characters are valid for the S92.122 subcategory. Character B designates the initial encounter for an open fracture. It means the patient is receiving active treatment for the first time, and the fracture involves a break in the overlying skin or soft tissue.

Related codes in the S92.122 family

S92.122B belongs to a tightly grouped code family, and coders move between its members on laterality, displacement, and encounter type. A nondisplaced talus fracture leaves this subcategory altogether for the S92.14- codes, such as S92.145K.

Clinical context: Displaced fracture of the left talus

The talus is the tarsal bone that connects the leg to the foot, and it forms the lower half of the ankle joint. It carries the body’s full weight load on a limited blood supply. That is why a displaced talus fracture brings a meaningful risk of avascular necrosis when treatment is delayed.

A displaced fracture means the bone fragments have shifted out of their normal alignment. An open fracture means the bone or the fracture site has breached the overlying skin or soft tissue. Both point to a higher-energy injury. Motor vehicle collisions, falls from height, and industrial accidents are the mechanisms documented most often.

Open vs. closed fracture: Choosing between S92.122A and S92.122B

The choice between S92.122A (closed) and S92.122B (open) drives most coding queries on this subcategory. The difference is clinical, and a coder cannot settle it independently. Three documented facts decide the code, and the record has to carry all three.

Per the ICD-10-CM Official Guidelines for Coding and Reporting (Section I.C.19), default to closed when the fracture type is not specified as open or closed. Assigning B without explicit documentation of an open fracture is upcoding, and it creates audit exposure.

Documentation requirements for S92.122B

Incomplete documentation is the main reason S92.122B claims are denied or downcoded. Review the medical record for all four elements below before you assign the code. Thorough documentation also keeps the claim clear of the denial codes payers reach for on open-fracture billing. It carries the appeal when one lands anyway.

• Laterality confirmed as left: The physician note, operative report, or radiology report must state the left foot or the left talus. A general reference to “the foot” is not enough.
• Displacement documented: The note should confirm that the fracture is displaced, meaning the fragments have shifted. “Nondisplaced” sends you to a different subcategory.
• Open fracture confirmed: The record must state “open fracture,” describe an open wound at the fracture site, or mention exposed bone. An operative wound classification such as Gustilo Type I also works.
• Initial encounter confirmed: The visit is active treatment, not a cast check, a post-op review, or a physical therapy session. Later visits in the same episode take D or the matching complication character.

Structured intake and clinical documentation tools make this far more reliable. The note has to capture all four elements at the time of the encounter, not weeks later when a coder queries the chart.

Associated CPT codes for talus fracture treatment

S92.122B is a diagnosis code, so it pairs with procedure codes that describe the treatment performed. The surgeon’s operative report governs CPT selection, not the diagnosis. The codes below are the ones most commonly associated with open talus fracture management.

CPT 28455 sits beside 28445 in the tarsal series, and it does not apply here. It covers treatment of a tarsal bone fracture with manipulation, and it excludes the talus. Check the descriptor in the AAPC ICD-10-CM lookup before a crosswalk goes out.

Applicable To notes and coding guidance

The ICD-10-CM tabular list carries no Applicable To notes unique to S92.122B. The broader S92 category does carry the convention that a fracture not indicated as open or displaced is coded to displaced and closed.

Two exclusions apply at the S92 category level, and both are worth checking whenever you review foot injury documentation:

• Excludes2 note at S92: Fracture of ankle (S82.-) is excluded from this category. A talus fracture is a foot fracture, so it is never coded to the S82 malleolar fracture codes.
• Index reference: The ICD-10-CM alphabetic index routes “fracture, traumatic, talus” to S92.1-, with laterality and displacement as the distinguishing factors.

How practice management software supports accurate ICD-10 coding

Open-fracture codes are denied at a high rate relative to how often they are billed. S92.122B needs four documented elements, and a claim that arrives missing one comes back as a rejection. That rework typically costs a billing team two to three weeks.

Pabau validates diagnosis and procedure codes before a claim leaves the practice. Its clearinghouse integration catches a mismatched ICD-10 and CPT pairing, or a missing modifier, at submission rather than at adjudication. Orthopedic and emergency medicine teams coding open fractures every week feel that front-end check first.

Pabau’s claims management software then carries the claim from documentation capture through denial follow-up. Billing staff code, submit, and work rejections in one place, so nobody rebuilds an open-fracture claim from a spreadsheet and a payer portal.

Reduce open-fracture claim denials with Pabau

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Conclusion

Open talus fractures are low-volume, high-complexity injuries, and one missing phrase in the record stalls the whole claim. S92.122B needs four facts confirmed: left laterality, displacement, open fracture status, and an initial encounter.

Check all four before the claim goes out, and query the provider whenever the note is ambiguous. That one habit prevents most rejections on this code, and it holds up when a payer audits the open-fracture designation later. Book a demo to see how Pabau validates ICD-10 coding and claims submission for orthopedic practices.

Continue your research

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