ICD-10 code S92.151B: Displaced avulsion fracture of right talus

Key takeaways

ICD-10 code S92.151B describes a displaced avulsion (chip) fracture of the right talus, initial encounter for open fracture

S92.151B is a billable ICD-10-CM code valid for HIPAA-covered transactions, effective October 1, 2025 for FY2026

The 7th character B designates an open fracture at initial encounter. Submitting A (closed) or D (subsequent) instead causes automatic claim denials

Pabau’s claims management software integrates with Claim.MD to submit ICD-10-CM codes including S92.151B electronically to 4,000+ US payers

ICD-10 code S92.151B is a billable ICD-10-CM diagnosis code representing a displaced avulsion fracture (chip fracture) of the right talus, initial encounter for open fracture. It became effective on October 1, 2025 as part of the FY2026 ICD-10-CM update and is valid for submission on HIPAA-covered transactions.

The code is published by the Centers for Medicare and Medicaid Services (CMS). The National Center for Health Statistics maintains it, in coordination with the World Health Organization.

Understanding the anatomy: What is the talus?

The talus is the ankle bone that sits between the heel (calcaneus) and the two bones of the lower leg (tibia and fibula). It bears the body’s full weight during standing and walking, making fractures at this site clinically significant.

A fragment can break away from the bone at the point of ligament or tendon attachment. That is classified as an avulsion fracture, also called a chip fracture.

Three documentation elements determine which S92.1x code applies. They are laterality, displacement status, and whether the overlying skin is intact or broken. Missing any one of them prevents clean-claim submission and triggers a documentation request from the payer.

• Laterality: S92.151B is right-side only. Left talus avulsion uses S92.152B. Unspecified laterality uses S92.153B.
• Displacement: displaced means the bone fragment has moved from its normal position. Nondisplaced equivalents use the S92.154x series.
• Open wound: the 7th character B requires clinical documentation confirming the fracture site communicates with the external environment (skin breach, puncture wound, or surgical approach).

S92.151B code hierarchy and parent codes

ICD-10 code S92.151B sits within the S92 chapter covering fractures of the foot, which itself falls under the S00-T88 injury and external causes block. Understanding the full hierarchy helps coders navigate to the correct level of specificity without stopping at a non-billable parent code.

The ICD-10-CM fracture code hierarchy follows a consistent parent-to-child logic across all traumatic injury chapters.

7th character breakdown: A, B, D, G, K, P, S

The 7th character in S92.151x is what makes the code billable and tells payers exactly which phase of care is being billed. ICD-10-CM coding conventions require the correct 7th character on every fracture claim. Submitting the wrong one is among the most common reasons fracture claims are denied outright.

The distinction between A (closed initial) and B (open initial) matters because open fractures carry higher surgical and reimbursement complexity. The same 7th character logic applies across every traumatic fracture category in ICD-10-CM.

Coding guidelines for ICD-10 code S92.151B: Open fracture initial encounter

Accurate use of ICD-10 code S92.151B depends on five documentation elements confirmed in the clinical note before claim submission. Skipping any one of them creates a payer audit trail or an outright denial. Catching a 7th character error at the documentation stage is far faster than working the denial afterward.

• Confirm right-side laterality. The note must explicitly state “right talus,” “right ankle,” or right-side anatomical reference. Bilateral or unspecified language redirects to S92.153B.
• Document displacement status. “Displaced” must appear or be clearly implied by imaging (fragment position described as shifted, unstable, or non-anatomic). If nondisplaced, use S92.154B instead.
• Specify fracture morphology. Avulsion or chip fracture terminology should appear in the radiology report or clinical impression. Fracture at a ligament or tendon insertion point is characteristic.
• Confirm open fracture. The note must document an open wound, skin laceration, puncture, or surgical communication at or near the fracture site. Without this, the closed-fracture code S92.151A applies.
• Designate initial encounter. The 7th character B applies only at first presentation for active treatment of this injury. All follow-up visits use D, G, K, or P depending on healing status.

Four of those five elements act as branch points. Avulsion morphology is what puts the note in the S92.15x family in the first place, so the other four decide which code inside it applies.

Documentation requirements for accurate coding

Per the ICD-10-CM Official Guidelines for Coding and Reporting, the provider’s documentation is the authoritative source for all coding decisions. For S92.151B specifically, the following must appear in the clinical record. A structured note template built around these five items keeps them in the chart rather than in the coder’s memory.

• Site confirmed as right talus (radiology report or clinical examination)
• Open wound or skin breach noted in physical examination findings
• Fracture displacement status stated or implied by imaging description
• Fracture type described as avulsion, chip, or equivalent anatomical terminology
• Encounter sequence confirmed as first presentation for this specific injury

Approximate synonyms and alternate descriptions

Multiple clinical phrasings map to ICD-10 code S92.151B. Coders searching by clinical terms rather than alphanumeric codes will encounter these alternate descriptions in the ICD-10-CM alphabetic index and commercial lookup tools. The ICD List free code browser and the AAPC Codify ICD-10-CM lookup both return S92.151B when searching these synonym terms.

• Chip fracture of right talus, initial encounter, open fracture
• Avulsion fracture right ankle bone, initial encounter for open fracture
• Displaced chip fracture right talus, open wound
• Open avulsion fracture right talus, first visit
• Right talus avulsion fracture with open wound, initial encounter
• Fracture at talar insertion, right side, open, initial

Related ICD-10-CM codes for talus fractures

S92.151B is one of several codes within the S92.1 (fracture of talus) subcategory. Knowing the sibling and adjacent codes prevents laterality or displacement errors at claim submission. The CDC/NCHS ICD-10-CM web tool allows year-specific browsing of the full S92.1 hierarchy, including all 7th character variants for each laterality-displacement combination.

The sibling codes below all sit on the talus itself. When the note points to a neighboring foot bone instead, start from the full list of ICD-10-CM codes.

Billing and claim submission for an open talus fracture

Once documentation supports ICD-10 code S92.151B, the code pairs with the appropriate CPT procedure code on the claim form before going to the payer. Open talus fractures typically require surgical management, so CPT codes in the 28000-28899 foot fracture range are common companions.

The most common root cause of an open fracture denial is a 7th character mismatch. Either A (closed) goes out when the note documents an open wound, or D (subsequent) goes out at the initial encounter. A clearinghouse edit catches both before the claim reaches the payer’s adjudication system.

Reviewing denial patterns by code with structured denial management workflows surfaces recurring S92.151B errors across a practice’s caseload.

How Pabau keeps talus fracture claims clean

Most practices assign S92.151B in the clinical record, then re-key it into a separate billing tool or a payer portal. Each hand-off is another chance for the 7th character to drift away from what the note actually says.

Practice management software like Pabau keeps the note and the claim on the same record. Its claims management software carries built-in ICD-10-CM catalogs, so a coder picks S92.151B against the encounter rather than typing it a second time.

The Claim.MD integration then submits the claim electronically to over 4,000 US payers. Real-time eligibility checks run before the surgical appointment, so the practice knows what the payer covers while the fracture is still being treated.

Submit fracture claims without re-keying the code

Pabau integrates with Claim.MD to send ICD-10-CM codes including S92.151B to over 4,000 US payers. Real-time eligibility checks, built-in code catalogs, and denial tracking all sit in one system.

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Conclusion

ICD-10 code S92.151B is only as good as the sentence in the note that supports it. Right-side laterality, displaced morphology, an open wound, and initial encounter status all have to be written down rather than inferred by the coder. One wrong character in the 7th position turns a billable claim into a denial.

So fix this at the point of documentation, not at appeal. Give the treating surgeon a note template that asks for all four elements, and the coder stops reconstructing them from an imaging report. Book a demo to see how Pabau submits ICD-10-CM claims, tracks denials, and checks eligibility in one system.

Continue your research

Need to manage fracture claim denials systematically? Denial codes in medical billing covers the most common CARC denial reasons and how to resolve them before resubmission.

Want to understand the clearinghouse submission process? Medical claims clearinghouse explains how claims flow from the practice to the payer and where errors are caught.

Looking for superbill documentation guidance? Superbill documentation walks through how to structure encounter summaries that support ICD-10 and CPT code pairing for clean claim submission.

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