ICD-10 Code S92.322D: Displaced second metatarsal fracture

Key takeaways

S92.322D covers a displaced fracture of the second metatarsal bone in the left foot, at a subsequent encounter with routine healing.

The 6th character carries displacement and side together, so 1, 2 and 3 are displaced right, left and unspecified foot.

The 7th character D marks a follow-up visit with normal healing, so submitting S92.322A at that visit is a frequent rejection cause.

S92.323D is the unspecified-foot version of the same fracture, so reach for it only when the record never names a side.

Practice management software like Pabau captures laterality, encounter type and the 7th character in the note, so claims carry the detail payers check.

ICD-10 Code S92.322D is a billable code for a displaced fracture of the second metatarsal bone of the left foot. It applies at a follow-up visit where the fracture is healing routinely. The side sits in the 6th character, where 2 means left, and the 7th character D marks the subsequent encounter.

Two details decide whether the claim clears. The record has to name the left foot, and the note has to show the encounter is a follow-up. The sections below cover the code hierarchy, the sibling codes in the S92.3 block, and the documentation each visit needs.

S92.322D: Full description and code overview

ICD-10 Code S92.322D describes a displaced fracture of the second metatarsal bone of the left foot. It applies at a subsequent encounter where the fracture is healing routinely. Every part carries a specific clinical and billing meaning, and all of them are needed for a correct submission.

The 6th character is the one to read twice. Within the second metatarsal group, 1 is a displaced fracture of the right foot, 2 is the left foot, and 3 is an unspecified foot. Nondisplaced fractures of the same bone run 4, 5 and 6 in the same order.

The code sits within the ICD-10-CM system, run jointly by CMS and NCHS. It falls under the S90-S99 chapter for injuries to the ankle and foot. ICD-10-CM is the US version of the WHO’s ICD-10 system.

What the 7th character D means for a subsequent encounter

The 7th character is where most coding errors for S92.322D occur. “D” does not mean the second visit or the fourth visit. It means any visit after the first active treatment visit, as long as the fracture is healing as expected. The grid below maps both variable digits at once.

Character D applies no matter how many follow-up visits have happened. What matters is whether the clinician is still treating the injury or watching a healing fracture. That has to be clear in the note for each visit.

The 7th character has to be right in the note before it reaches the claim. Practices that record the encounter type at documentation time avoid rebilling later. Practice management software like Pabau keeps that detail on the record. Its claims management software then carries it into the submission, so the biller is not rebuilding it from the chart.

Where the code sits in the ICD-10-CM hierarchy

S92.322D sits within a defined parent structure. Reading the hierarchy from the top down helps coders pick the right level of detail. It also makes the nearby codes easy to find when laterality or displacement status differs.

Two points in that table catch coders out. S92.32 is the general parent for a second metatarsal fracture, so displaced, nondisplaced and unspecified codes all sit beneath it. S92.322 on its own is also not billable, because every complete code in the S92 category needs a 7th character.

Clinical context: displaced fracture of the second metatarsal, left foot

The second metatarsal is the longest metatarsal bone and the one most often broken under stress. It acts as the central weight-bearing pillar of the midfoot. That leaves it exposed during sudden changes of direction, falls from height, or a direct impact to the dorsum of the foot.

A displaced fracture means the bone fragments have moved out of place. Displacement drives the treatment decision. A non-displaced second metatarsal fracture is often managed with a walking boot. A displaced one may need closed reduction, or surgical fixation, before the subsequent-encounter phase begins.

Laterality is a required element of the note, and it is what separates S92.322D from its two neighbors. A note that records only “foot fracture” supports S92.323D (unspecified foot) at best. Many payers treat that as an unspecified-diagnosis denial.

The imaging report is not a substitute. If the radiologist writes “left” and the clinician writes nothing, the encounter note still fails an audit of the coded side.

• Common mechanisms: Sports injuries, falls from height, direct crush injury, high-energy vehicular trauma
• Displacement significance: Determines conservative versus operative management before subsequent-encounter coding begins
• Laterality requirement: The clinical note, imaging report, and operative record must all specify left foot
• Fracture type check: Radiographic evidence of displacement should be noted or available in the chart for audits

Other ways this code is described

The wordings below are documentation phrasings that map to S92.322D. None is the official descriptor. That reads “Displaced fracture of second metatarsal bone, left foot, subsequent encounter for fracture with routine healing”, and it carries no “closed” qualifier. Check the Alphabetic Index and Tabular List before you choose the final code.

• Displaced fracture of left second metatarsal bone, subsequent encounter, routine healing
• Subsequent encounter for displaced fracture of the 2nd metatarsal bone, left foot
• Follow-up visit for a displaced second metatarsal fracture of the left foot, healing well
• Displaced left foot second metatarsal fracture, subsequent care, routine healing

These wordings help most when an auditor is matching the note against the coded diagnosis. The AAPC Codify ICD-10-CM lookup carries a synonyms section for the code, which is a quick way to cross-check the language a clinician actually used.

Related ICD-10-CM codes for metatarsal fractures

The S92.3 block covers every metatarsal fracture. The table below lists the siblings coders reach for most often around S92.322D. Watch how the 6th character moves. 1 is the right foot, 2 is the left, and 3 is unspecified, in the displaced and nondisplaced groups alike.

Working down the S92.3 block in order lowers the risk of picking a nearby code with a different displacement or laterality qualifier. When claims for any of these codes are denied, tag each denial by ICD-10 code family. Our reference on denial codes explains what each rejection reason means.

Tagging that way shows patterns across the whole S92 block, instead of one rejected claim at a time.

Documentation that supports S92.322D at each visit

Getting S92.322D accepted on first submission takes documentation that supports every qualifier in the code. Five qualifiers carry it. They are the bone, the side, the displacement status, the encounter type, and the healing status. A miss on any one creates audit exposure.

When to use D versus A versus G

Switch from A to D once the active treatment phase ends. For a conservatively managed displaced second metatarsal fracture, this often means the first follow-up after the fracture is reduced or immobilized. For a surgically managed fracture, it means follow-up after surgery, once early recovery care is complete.

Use G (delayed healing) when the clinical note documents that expected healing milestones have not been met. Continuing to use D while imaging or clinical findings show delayed healing is a coding accuracy issue. The CDC/NCHS ICD-10-CM web tool carries the official tabular guidance on 7th character selection for S92 category codes.

Documentation elements required

• Laterality: “Left foot” must appear in the clinical note, not be inferred from imaging alone
• Bone detail: “Second metatarsal” must be named. “Metatarsal fracture” without a bone number is not enough
• Displacement check: “Displaced” must be documented, or backed by an imaging report describing fragment migration
• Encounter context: The note must establish this is a follow-up, and that the acute phase is complete
• Healing assessment: Words such as “healing well,” “routine progress,” or “callus formation noted” support the routine healing qualifier

POA indicator for subsequent encounter codes

Subsequent encounter codes, including S92.322D, are exempt from Present on Admission (POA) reporting requirements. The POA indicator is required only for inpatient diagnoses present at the time of hospital admission. For outpatient fracture follow-up visits, POA does not apply.

Practices submitting through Pabau’s Claim.MD integration send claims in the CMS-1500 and 837P formats. Those are the standard submission paths for outpatient foot fracture follow-up encounters. The integration moves the claim to the payer and tracks its status. Choosing the 7th character stays with the coder and the note.

Common coding errors for S92.322D

• Using S92.322A at follow-up visits: Once the first encounter is complete, all follow-up visits under routine healing require the D character
• Submitting S92.322 without a 7th character: S92.322 alone is not billable and will be rejected
• Wrong laterality: Selecting S92.321D (right foot) or S92.323D (unspecified foot) when the record says left. Payers check laterality against procedure codes and operative reports
• Failing to switch to G when healing plateaus: Using D while the notes describe stalled healing is a coding error, not only a billing risk
• Incomplete documentation: A note that does not name “second metatarsal” does not support S92.322D, whatever the imaging report shows

Code history and annual update context

S92.322D has been in the ICD-10-CM Tabular List since the US rollout on October 1, 2015. The FY2026 edition took effect on October 1, 2025 under the standard CMS annual update cycle. It carried no change to the code’s description, its billable status, or its 7th character assignments.

Annual ICD-10-CM updates sometimes retire, revise, or add codes within the S92 block. Check any code’s edition status against the CMS ICD-10 codes page at the start of each fiscal year. Practices that refresh their code library every October 1 avoid coding on retired or revised descriptions.

For coders using the global system, the WHO ICD-10 browser holds the parent version. ICD-10-CM differs from the WHO edition in its level of detail. The clearest example is the 7th character on injury codes, which the WHO version does not carry in the same form.

Billing and claim submission

Claims for subsequent encounter fracture visits often pair S92.322D with an evaluation and management (E/M) code or a physical therapy procedure code. Which one depends on the treating provider and on what the follow-up visit involved. The diagnosis code alone does not determine reimbursement. It has to be paired with a procedure code that reflects the services given.

For practices billing US insurance, the electronic remittance advice from each payer shows whether S92.322D was accepted, adjusted, or denied. Monitoring that data by ICD-10 code family lets billing teams spot repeat coding issues before they compound across patients.

Retention rules apply to the supporting documentation too. Keep the note that explains the 7th character for each visit, because that is what an auditor asks for. Our guide to a clean claim covers what has to be in place before submission.

How Pabau supports fracture follow-up claims

Most practices keep the coding detail for a fracture episode in three separate places:

• The clinician’s note, which names the side, the bone and the healing status
• A spreadsheet or worklist tracking which follow-up visits still need billing
• The clearinghouse portal, which holds the claim’s status after submission

Matching the three by hand is where the encounter type gets lost. A visit coded A in the note becomes a visit billed A six weeks later, long after the fracture moved on to routine healing.

Pabau keeps them on one record. The diagnosis code the clinician enters at the follow-up visit stays attached to that appointment. The invoice and the claim are then raised from the same record, so nobody retypes the code into a second system.

Pabau’s Claim.MD integration submits and tracks those claims for thousands of US payers, and checks eligibility in real time. That matters for fracture follow-up patients, whose coverage may have changed since the first visit. Choosing the code and writing the note that supports it stay with your clinical team.

Document fracture follow-ups accurately with Pabau

Pabau records ICD-10 codes, encounter types and laterality in the clinical note, and raises the claim from that same record. See how the claims management tools and the Claim.MD integration keep foot fracture follow-up billing on one system.

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Conclusion

A displaced second metatarsal fracture generates a sequence of coding decisions across the episode of care. S92.322D carries the bulk of the follow-up billing for left-foot cases that are healing well.

Two habits keep it clean. Write the side and the healing status into every follow-up note, and move to G the first time the imaging stops agreeing with “routine”. Both are documentation decisions, made at the visit rather than at the claim.

Book a demo to see how Pabau keeps the side, the encounter type and the healing note attached to the claim it bills.

Continue your research

Managing complex fracture billing workflows? Denial management in healthcare covers how to build a systematic response to claim rejections across ICD-10 code families.

Need to understand the full claims submission process? Pabau’s Claim.MD clearinghouse guide explains how electronic claim submission works from code selection through remittance.

Looking for compliance documentation standards? Medical billing compliance outlines the record retention and documentation accuracy requirements for subsequent encounter fracture codes.

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