ICD code S92.321D – Displaced fracture of second metatarsal bone

Key takeaways

ICD-10 code S92.321D describes a displaced fracture of the second metatarsal bone, right foot, at a subsequent encounter with routine healing.

The 7th character D applies to follow-up visits once the fracture is healing normally, and billing A instead is a leading denial cause.

S92.321D is billable for FY2026, the year running October 1, 2025 through September 30, 2026.

Subsequent encounter codes are exempt from Present on Admission reporting, so no POA indicator is needed on the claim.

Practice management software like Pabau keeps encounter type in the record, so coders pick the right 7th character without a provider query.

ICD-10 Code S92.321D: Code details at a glance

S92.321D is a billable, valid ICD-10-CM diagnosis code for FY2026. The table below summarizes the administrative attributes coders need before submitting a claim.

Verify billable status each year against the CMS ICD-10 codes page, since validity and descriptions can change with the fiscal year update. The CDC/NCHS ICD-10-CM web tool also gives year-specific tabular lookups from the official source.

What does S92.321D mean? Breaking down the code structure

ICD-10-CM fracture codes follow a hierarchical structure, and each segment of S92.321D encodes one clinical attribute. Coders who know the structure can build the correct code from the documentation instead of memorizing individual codes.

The parent code S92.321 is a non-billable header code, so it is not valid on a claim without a 7th character. Every claim carries the full 7-character code, and the 7th character has to match the encounter type and healing status in the record.

The 7th character D: Subsequent encounter with routine healing

The ICD-10-CM Official Guidelines define a subsequent encounter as any visit after the patient has received active or definitive treatment. Care at that point is routine, during the healing or recovery phase.

Follow-up visits, cast checks, fracture care oversight, and physical therapy coordination all qualify, even when a different provider delivered the original treatment.

A wrong character here is one of the more preventable denials in fracture billing. Good denial management catches it at the coding stage rather than on appeal. All valid 7th characters for S92.321 are listed below.

Key distinction: D applies whenever the fracture is healing on a normal trajectory. Switch to G when imaging or clinical assessment shows delayed healing. Nonunion (K) and malunion (P) need documented radiographic or clinical findings behind them.

Using D where G, K, or P is more accurate understates the complexity of the care being given. Work the choice in that order, treatment question first, then healing status.

Clinical presentation: Displaced second metatarsal fracture, right foot

A displaced fracture of the second metatarsal is a break where the bone fragments have shifted out of normal anatomical alignment. The second metatarsal is the longest of the five and carries heavy load during gait, which makes it prone to traumatic and stress fracture alike.

Common causes include a direct crush injury, twisting trauma, or a high-energy impact. Laterality is a required documentation element. The right foot has to be stated in the initial assessment note and carried through every subsequent note.

Approximate synonyms

The following clinical terms all map to ICD-10 Code S92.321D and may appear in operative reports, discharge summaries, or consultation notes:

• Closed displaced fracture of second metatarsal bone, right foot, subsequent care
• Displaced fracture right 2nd metatarsal, follow-up encounter, routine healing
• Subsequent visit, right foot second metatarsal displaced fracture, healing normally
• Fracture second metatarsal right foot, follow-up, uncomplicated healing
• Second metatarsal bone fracture, displaced, right, subsequent encounter

Coding guidelines and documentation requirements

Documentation has to support three elements before S92.321D can be used, and the checklist below sets them out. Per the ICD-10-CM Official Guidelines for Coding and Reporting, a subsequent encounter is any encounter after active treatment has been provided. The current provider does not have to be the one who delivered that treatment.

The 7th character reports the phase of care, not the severity of the visit. A complex follow-up with a new X-ray and a change in management still takes D, as long as healing is progressing normally. Only a documented complication moves the character to G, K, or P.

Documentation checklist

• Fracture type: Displaced (not non-displaced) – must be stated or inferable from imaging
• Bone specificity: Second metatarsal bone (not just “metatarsal fracture”)
• Laterality: Right foot – explicit in the clinical note or imaging report
• Encounter type: Subsequent – the patient has already received initial active treatment
• Healing status: Routine – clinical or radiographic evidence of normal healing progression
• External cause: Code separately using V00-Y99 if required by payer or facility policy

A referral note on its own is not enough to assign S92.321D. The treating clinician’s documentation at the encounter has to support every element above. If healing status is missing, query the provider before coding.

Present on Admission (POA) reporting

S92.321D is exempt from Present on Admission (POA) reporting. Subsequent encounter codes carry an inherent temporal component, because by definition the fracture occurred before the current encounter.

CMS therefore excludes them from the POA reporting requirement on inpatient claims. That removes one administrative step, though coders should still confirm their facility’s POA policies, since some payers add requirements beyond the CMS baseline.

MS-DRG and outpatient grouping

MS-DRG assignment depends on the principal diagnosis, secondary diagnoses, procedures performed, and patient age and sex. The code alone never determines a DRG.

Where S92.321D is the principal diagnosis on an inpatient claim, it typically maps to the foot and ankle fracture groupings inside Major Diagnostic Category 8. Weights and groupings shift with each fiscal year update to the CMS MS-DRG Definitions Manual, so check the active version rather than a prior-year table.

S92.321D shows up far more often in outpatient settings, where MS-DRG does not apply at all. Outpatient claims for subsequent fracture encounters group under the Ambulatory Payment Classification (APC) system instead, which follows different clean-claim rules from inpatient DRG logic.

Related ICD-10-CM codes for displaced second metatarsal fractures

S92.321D sits inside a set of closely related codes that share the same clinical category. Coders working foot fracture encounters cross-reference these codes to confirm laterality, displacement status, and encounter type.

For code lookups and crosswalk verification, the AAPC Codify ICD-10-CM lookup gives free access to the full S92 category with DRG grouper integration.

Commonly used CPT codes with S92.321D

Subsequent encounters for a displaced second metatarsal fracture usually involve evaluation and management, fracture care oversight, or an adjunctive procedure. The codes below are the ones most often paired with S92.321D at follow-up.

Check medical necessity pairing against the payer’s Local Coverage Determination (LCD) first, because coverage rules vary. Our CPT code reference covers the wider procedure-code families that foot and ankle follow-up visits draw on.

Global fracture care packages include routine follow-up visits within the global period, and CPT 28470 for closed treatment of a metatarsal fracture is one example. Say the initial treatment was billed under a global fracture care code. A separate E/M inside the global period then needs modifier -24, unless a specific exception applies.

Verify global period days with the ResDAC coding resources guide or the CMS Physician Fee Schedule before billing separately.

Code history and effective dates

S92.321D arrived with the ICD-10-CM implementation and has been billable since ICD-10-CM replaced ICD-9-CM in October 2015. The code has stayed stable through the annual updates since.

Its FY2026 validity period runs from October 1, 2025 through September 30, 2026, as confirmed by the CMS and NCHS annual update process. Check the CDC/NCHS tabular list each October for revisions to the S92 category before the new fiscal year starts.

How claims software keeps subsequent fracture encounters clean

In a paper or split-system workflow, the encounter type lives only in the clinician’s narrative. The coder reads the note, works out whether active treatment already happened, then often queries the provider before the claim goes out. Every one of those queries is a day of aging on the account.

Practice management software like Pabau keeps the appointment, the treatment note, and the claim in one record. Pabau’s claims software for coders carries the diagnosis code from the note onto the claim. The 7th character then travels with the visit it describes, and billing staff can see at a glance which encounters already had active treatment.

The outcome is fewer follow-up claims going out with an initial-encounter character on them. Fewer denials means less rework for the billing team and faster payment on fracture care. Nobody has to chase a note to work out which visit came first.

Reduce fracture claim denials with smarter billing workflows

Pabau helps podiatry and orthopedic teams manage ICD-10-CM coding, clean claim submission, and follow-up encounter tracking in one platform. See how it fits the way your practice already works.

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Conclusion

The 7th character is a documentation problem before it is a coding problem. If the record names the phase of care and the healing status, S92.321D either fits or it does not. The coder never has to guess, and the claim goes out right the first time.

So the work worth doing sits upstream of the claim. Label the initial visit as active treatment while it is happening, then document healing progression at every follow-up. The correct 7th character falls out of a record kept that way, and a look at the S92 category each October keeps it current.

Book a demo to see how Pabau keeps encounter type and healing status in the record your coders bill from.

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