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

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: 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

Foot fracture claims get rejected for two reasons more than any other. One is the wrong side. The other is the wrong 7th character. ICD-10 Code S92.322D carries both details for a displaced second metatarsal fracture of the left foot at a follow-up visit. The side sits in the 6th character, where 2 means left, and claims are lost by reaching for the neighboring 1 or 3 instead.

This reference covers the full description of ICD-10 Code S92.322D and its billable status. It also sets out the 7th character framework, the code hierarchy, and the sibling codes in the S92.3 block. Accepted alternate wordings and the documentation each follow-up visit needs come after that.

ICD-10 Code 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 component carries a specific clinical and administrative meaning, and all of them are required for accurate 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 maintained jointly by CMS and NCHS, under the broader S90-S99 chapter covering injuries to the ankle and foot. It is the American clinical modification of the international WHO ICD-10 classification.

Understanding the 7th character ‘D’: subsequent encounter fracture ICD-10

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 initial active treatment encounter, provided the fracture is healing as expected.

The fracture routine healing ICD-10 designation (character D) applies regardless of how many follow-up appointments have occurred. What matters is whether the treating clinician is still actively managing the acute injury versus monitoring a healing fracture. This distinction must be explicit in the documentation for each encounter.

Some claims management software flags a missing 7th character at the point of documentation rather than at claim submission. Practices on that setup catch the error before it affects reimbursement. Learn more about what accurate medical billing requires at each stage of a fracture episode.

S92.322D code hierarchy and classification

S92.322D sits within a defined parent structure. Reading the hierarchy from the top down helps coders pick the right level of specificity. It also makes the adjacent 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. And S92.322 on its own is not billable, because every complete code in the S92 category needs a 7th character. For physical therapy practices managing fracture rehabilitation, the physical therapy EMR must support full 7-character ICD-10-CM code entry to avoid truncation errors.

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

The second metatarsal is the longest metatarsal bone and the one most commonly fractured 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 shifted out of anatomical alignment. 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.

The Ottawa ankle and foot rules guide clinicians in the emergency setting on when to image a suspected foot fracture. 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, which many payers treat 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 vs. operative management before subsequent-encounter coding begins
• Laterality requirement: The clinical note, imaging report, and operative record must all specify left foot
• Fracture type confirmation: Radiographic evidence of displacement should be referenced or available in the chart for audit purposes

Approximate synonyms and alternate descriptions for S92.322D

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 finalizing any code selection.

• 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 normally
• Displaced left foot second metatarsal fracture, subsequent care, routine healing

These wordings help most when an auditor is reconciling 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.

For practices managing multiple foot fracture patients, the ICD List provides a browsable S92 block that helps coders verify sibling codes quickly. Efficient navigation of the S92.3 block reduces the risk of selecting an adjacent code with different displacement or laterality qualifiers.

When claims for any of these codes are denied, tag each denial by ICD-10 code family. Denial management workflows built that way show patterns across the whole S92 block, instead of one rejected claim at a time.

Coding tips and documentation requirements for fracture routine healing ICD-10

Getting ICD-10 Code S92.322D accepted on first submission takes documentation that supports every qualifier in the code. There are five of them: the bone (second metatarsal), the side (left), 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 typically means the first follow-up appointment after the initial reduction or immobilization encounter. For a surgically managed fracture, it means post-operative follow-up visits once the immediate post-operative care is complete.

Use G (delayed healing) when the clinical note documents that expected healing milestones have not been met. Continuing to use D when imaging or clinical findings show delayed or absent healing is a coding accuracy issue that can affect medical record integrity. The CDC/NCHS ICD-10-CM web tool provides 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 inferred from imaging alone
• Bone specificity: “Second metatarsal” must be identified; “metatarsal fracture” without bone number is insufficient
• Displacement confirmation: “Displaced” must be documented or supported by an imaging report describing fragment migration
• Encounter context: The note must establish this is a follow-up (not an initial presentation) and that treatment is ongoing but 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 (the typical context for subsequent encounter codes), POA does not apply.

Practices submitting through a Claim.MD clearinghouse integration get built-in ICD-10 code validation. It catches formatting errors, missing 7th characters, and POA-exempt code handling before a claim reaches the payer. The integration supports both CMS-1500 and 837P electronic claim formats, which are the standard submission paths for outpatient foot fracture follow-up encounters. For more on how clean claim submission affects reimbursement timelines, see the guide on what makes a clean claim.

Common coding errors for S92.322D

• Using S92.322A at follow-up visits: Once the initial 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 S92.322D (unspecified foot) when the record says left – payers validate 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 inaccuracy, not only a billing risk
• Incomplete documentation: Documentation that does not specify “second metatarsal” by name does not support S92.322D regardless of what the imaging report shows

Code history and annual update context

S92.322D has been in the ICD-10-CM Tabular List since the US implementation 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 occasionally 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. October 1 is the date, and the check confirms the code is still active and unchanged. The annual ICD-10-CM update cycle touches codes in every chapter. Practices that refresh their code library each October 1 avoid coding on retired or revised descriptions.

For coders referencing the international classification, the WHO ICD-10 browser provides the parent international version. The ICD-10-CM (US clinical modification) differs from the international edition in its code granularity. 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 for S92.322D

Claims for subsequent encounter fracture visits usually 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 must be paired with a procedure code that reflects the services actually rendered.

For practices billing through US insurance, electronic remittance advice (ERA) reports from payers will indicate whether S92.322D was accepted, adjusted, or denied. Monitoring ERA data by ICD-10 code family allows billing teams to spot systematic documentation or coding issues before they compound across multiple patients.

Understanding how revenue cycle management connects documentation to reimbursement helps practices treat coding accuracy as a clinical workflow issue, not just an administrative one. The medical billing compliance requirements for subsequent encounter fracture codes include retaining the documentation that supported the 7th character selection for each visit.

For practices using Pabau, the claims management platform supports CMS-1500 submission with ICD-10-CM code validation. The Claim.MD integration routes claims to over 4,000 US payers and checks eligibility in real time. That matters for fracture follow-up patients, whose coverage may have changed since the initial encounter.

Document fracture follow-ups accurately with Pabau

Pabau captures ICD-10 codes, encounter types, and laterality in clinical notes and connects directly to billing workflows. See how Pabau’s claims management and Claim.MD integration reduces coding errors for foot fracture follow-up visits.

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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 normally. Getting it right means documenting the side, the bone, the displacement and the healing status at every visit. Switch to G when the clinical picture changes.

Pabau’s claims management tools help practices capture and validate the documentation that supports codes like S92.322D before claims reach the clearinghouse. To see how Pabau handles ICD-10 coding workflows across fracture episodes, book a demo.

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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