ICD code S92.131D – Displaced fracture of posterior process of right talus

Key takeaways

S92.131D covers a displaced fracture of the posterior process of the right talus at a follow-up visit with routine healing.

The 7th character is mandatory, so the parent code S92.131 cannot be submitted for reimbursement on its own.

Nondisplaced right talus is S92.134, not S92.133, which reports a displaced fracture with the side left undocumented.

Your note must confirm the site, the right side, displacement, and routine healing, or the code cannot be defended.

Pabau’s claims management software pre-fills the claim from the record and submits it to thousands of US payers through Claim.MD.

S92.131D is billable, but only with its 7th character

S92.131D is a valid, billable ICD-10-CM diagnosis code. Payers accept it in every HIPAA-covered transaction. Both the CDC/NCHS ICD-10-CM web tool and the CMS ICD-10 codes page list it as a complete code.

Its official description runs long for a reason. Displaced fracture of posterior process of right talus, subsequent encounter for fracture with routine healing.

Every clause in that string has to be matched by something in the chart. That means site, side, displacement, encounter type, and healing status all have to appear before you can use it.

What the 7th character D tells a payer

D says two things at once. Active fracture treatment has finished, and the bone is knitting the way it should, with no delayed union, nonunion or malunion on record. The AAPC’s ICD-10-CM code reference puts it plainly. D applies while the patient is still receiving care after that active phase has closed.

Misapplying the character is one of the most common fracture coding errors. Leaving A on a follow-up visit, or reaching for D when the radiograph shows delayed union, both trip automated payer edits.

Section I.C.19 of the ICD-10-CM Official Guidelines for Coding and Reporting governs how these characters get assigned for traumatic fractures.

Every 7th character in the S92.131 family

On its own, S92.131 is a placeholder. Add one of the seven characters below and it becomes something you can put on a claim.

What a posterior talar process fracture looks like in the chart

The posterior process is a small bony projection at the back of the talar body. Two tubercles, medial and lateral, sit either side of the groove that carries the flexor hallucis longus tendon.

These fractures turn up far less often than talar neck or body fractures, and they are easy to miss on plain film. The posterior tibiotalar joint and the tendon both run past the fragment, so an overlooked injury often becomes chronic posterior ankle pain.

Displaced means the fragments have moved out of anatomical alignment. That one word is what separates the S92.131x codes from the nondisplaced ones, which start at S92.134 for the right side.

• Mechanism: forced plantar flexion, usually from a fall from height, a motor vehicle accident, or a direct crush injury to the hindfoot
• Presentation: posterior ankle pain, swelling behind the lateral malleolus, pain on passive dorsiflexion of the big toe, and tenderness over the posterior talar process
• Imaging: standard ankle radiographs often miss a subtle posterior process fracture, so CT is usually needed to confirm displacement and fragment size
• Treatment: displaced fractures generally need surgical fixation, or in selected cases immobilization with close radiographic follow-up
• Coding at follow-up: once active treatment ends and the patient returns for healing checks, rehab or cast management, S92.131D applies

Matching the encounter to the right 7th character

Three conditions have to hold before D is correct. Active treatment has finished, the fracture is healing as expected, and no complication is documented. If any one of them fails, a different character applies instead.

One nuance is worth flagging. The switch from S92.131A to S92.131D is not a calendar event, and no fixed number of days triggers it. It happens when the treating clinician documents that active treatment has ended and routine monitoring has begun.

Coders should follow that documented intent rather than overriding it with a rule of thumb.

The six posterior-process codes that get mixed up

Laterality and displacement between them generate six separate codes inside S92.13, and two pairs get swapped often enough to be worth memorizing. The grid below lays all six out at once.

Outside the posterior process, the talus carries its own neck, body and dome codes, and the calcaneus sits in a separate subcategory altogether. The table below covers the siblings that show up most often on fracture follow-up claims, all shown with the D character for comparison.

Where S92.131D sits in the ICD-10-CM tabular list

Walking the tabular list from the top explains why the parent code is unbillable. Specificity has to run all the way to the bottom of the branch before a payer will take it.

• Chapter S00-T88: injury, poisoning and certain other consequences of external causes
• Block S90-S99: injuries to the ankle and foot
• Category S92: fracture of foot and toe, except ankle
• Subcategory S92.1: fracture of talus
• Subcategory S92.13: fracture of posterior process of talus
• Code S92.131: displaced fracture of posterior process of right talus, still not billable
• Code S92.131D: the same fracture at a subsequent encounter with routine healing, billable

S92.131 without a 7th character cannot go on a claim at all. Payers running ICD-10-CM validation edits reject it long before a human reviewer sees it. The same drill-down governs every family in our ICD-10-CM code library. So when you code fractures at several sites, work from the tabular list rather than from memory.

CPT codes that pair with S92.131D at follow-up

S92.131D lands on subsequent-encounter claims, so the CPT codes beside it describe follow-up care rather than the original repair. The procedure performed at that visit decides which one you report.

Most of these visits land on 99213, so it pays to know where that level sits under the current medical decision-making rules. The codes for the original repair are a different matter.

Open treatment of a talus fracture is 28445, not 28455, which explicitly excludes the talus and calcaneus. Neither one pairs with S92.131D at a follow-up visit unless a fresh procedure is performed that day.

Documentation that holds the code up at audit

Supporting S92.131D on review means the note confirms every clause of the description. Miss one, and a post-payment audit can claw the money back months after the claim was paid.

• Fracture site confirmed: the note names the posterior process of the talus, not “ankle fracture” or “foot fracture”. A reference to the imaging report showing posterior talar process involvement is enough.
• Laterality documented: right foot or right talus appears in the assessment or the problem list. Bilateral or unspecified laterality sends you to a different code.
• Displacement stated: the clinician notes that the fracture was displaced, or was treated as displaced. If the record only shows nondisplaced, S92.134D is the correct code.
• Encounter type described: the note makes clear this is a follow-up. Phrases such as “returns for fracture follow-up”, “post-operative visit” or “week six check” all work.
• Routine healing confirmed: the clinician states that healing is on track, typically with something like “expected callus formation” or “healing well on X-ray”. Without it, a coder has to query the provider before assigning D.

Before you submit: a five-point claim check

Fracture claims fail for a short list of reasons, and every one of them is catchable before the claim leaves the practice. Run this pass over each S92.131D line.

1. Is there a 7th character? A bare S92.131 dies at the clearinghouse, so it never reaches the payer at all.
2. Does the note name the side? A chart that says only “talus fracture” pushes you to S92.133D, which draws far more payer scrutiny.
3. Does it say displaced? Without that word in the record, the defensible code is S92.134D.
4. Is routine healing stated? Wording like “expected callus formation” supports D. Silence on healing status means a provider query.
5. Is the encounter clearly a follow-up? “Returns for fracture check” or “week six review” supports the subsequent-encounter character.

From there, the claim follows the usual path. The charge line carries the CPT code and the diagnosis pointer. The clearinghouse then runs its ICD-10-CM validation edits, and the payer applies its own medical necessity rules on top.

The two failure modes behave very differently. A 7th character error usually dies within minutes, at the clearinghouse. A displacement or laterality error sails through, gets paid, and only surfaces in an audit a year later.

Mechanical errors are the ones claims management software should catch for you, so the coder’s attention stays on the clinical judgment.

How Pabau keeps fracture coding and claims in step

In a lot of practices, the fracture gets coded in one place and the claim goes out from another. The note sits in the chart, the code gets keyed into a billing screen, and nobody compares the two until a denial lands.

Practice management software like Pabau closes that loop. Pabau’s claims management software pre-fills the CMS-1500 straight from the record. The CPT code attached to the service lands on the charge line. ICD-10 slots are seeded from the client’s recorded problem list.

Built-in ICD-10-CM and CPT lookup libraries sit behind a search icon on the claim. A coder can check S92.134 against S92.133 without leaving the screen. Before the send button unlocks, Pabau confirms that the claim’s required fields are all complete.

From there, US practices submit through Claim.MD to thousands of US payers. Eligibility checks, claim status tracking and remittance posting all come back down the same pipe. Fewer fracture claims bounce for something the record already answered.

Keep fracture codes and claims in one system

Pabau’s claims management software pre-fills the claim from the patient record, checks the required fields, and submits through Claim.MD to thousands of US payers. Fewer fracture claims come back for a coding detail the chart already held.

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Conclusion

Four facts decide whether S92.131D survives a review, and they are site, side, displacement and healing status. Build all four into your fracture follow-up template as structured fields, and the coder stops guessing.

The trade-off worth remembering is that a 7th character error is cheap and a laterality error is expensive. The first bounces back the same day. The second gets paid, sits quietly, and turns up in a post-payment audit a year later.

A chart in one system and a billing screen in another is exactly how that second error survives. Book a demo to see how Pabau pulls the note, the code and the claim into one record.

Continue your research

Coding a talus fracture that stopped healing? ICD-10 code S92.145K walks the same 7th character logic through a nonunion encounter.

Need the higher E/M level for a complex follow-up? CPT code 99214 sets out when a visit earns moderate medical decision-making.

Want to know what a payer counts as a clean claim? Clean claim submission standards lists what has to be present before a claim can pay first time.

Fracture claims coming back denied? Denial management in healthcare covers the workflow for catching coding errors before they cost revenue.

Building the encounter record your coder works from? Superbill documentation explains which fields belong on the form and why encounter type matters.

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