ICD-10 code S92.332A: Displaced third metatarsal fracture, left foot

Key takeaways

S92.332A is a billable ICD-10-CM code for a displaced fracture of the third metatarsal bone, left foot, initial encounter for closed fracture.

It is valid for the FY2026 edition of ICD-10-CM. The 7th character A marks the initial encounter, and six extensions cover the care continuum through sequela.

Documentation must specify four elements: Displacement, laterality, bone, and encounter type. Missing any one of them invites a denial or a downcode.

Practice management software like Pabau keeps the clinical note, the invoice, and the electronic claim in one system. The specificity in the note then carries through to the payer.

ICD-10 code S92.332A is the billable diagnosis code for a displaced fracture of the third metatarsal bone, left foot, initial encounter for closed fracture. It is valid for the FY2026 edition of ICD-10-CM, effective October 1, 2025. You can submit it directly for reimbursement without further specificity. No additional code is needed to capture laterality, displacement, or bone identity.

The parent subcategory S92.3 covers fractures of the metatarsal bones broadly. S92.332 is the six-character base code for a displaced fracture of the third metatarsal, left foot. The appended seventh character A narrows that to the initial encounter for a closed fracture.

Per CMS ICD-10-CM guidance, a code that requires a 7th character is not valid for billing without it. Submit S92.332 on its own and the claim comes back invalid.

Code details at a glance

The table below provides the complete reference snapshot for S92.332A. Use it for quick verification during coding, auditing, or payer correspondence.

7th character extensions for S92.332

S92.332 requires a 7th character on every claim. The character captures the encounter phase and, at follow-up visits, the healing status of the fracture. Picking the wrong one is a common audit finding in orthopedic billing. The same logic runs through every traumatic injury category in Chapter 19, including ICD-10-CM fracture sequela coding for other body regions.

Per the ICD-10-CM Official Guidelines, “initial encounter” applies each time the patient receives active treatment for the condition. It is not limited to the first calendar visit.

Say a patient fractures the foot on Monday and sees a primary care physician on Tuesday. She then sees an orthopedic surgeon on Thursday for cast application. Both visits take 7th character A, because a treatment decision is made at each one.

When to use S92.332A: Initial encounter guidelines

For 7th character A, active treatment is the deciding factor. The CDC/NCHS ICD-10-CM tool defines it as any encounter where the provider makes a treatment decision for the current fracture. That covers closed reduction, casting, splinting, surgical planning, and a referral for surgery.

Use S92.332A when

• The visit involves casting, splinting, or closed reduction of the displaced third metatarsal fracture on the left foot
• The patient is presenting for a second opinion and a new treatment plan is being established
• A surgical consult is taking place with operative planning documented in the note
• The fracture is being re-evaluated after initial imaging and a new management decision is made

Do not use S92.332A when

• The visit is a routine cast check with no change in management (use S92.332D)
• The fracture has healed and the patient presents with a residual complication (use S92.332S or S92.332P as appropriate)
• Imaging confirms nonunion or malunion at a follow-up appointment (use S92.332K or S92.332P)

Practices that rely on clean claim submission workflows can build these 7th character rules into the note template itself. Catching an incorrect encounter type at the point of documentation beats catching it at the clearinghouse.

What the clinical note must document

Four documentation elements are required to support ICD-10 code S92.332A. Leave one out and the payer can downcode the claim or deny it outright. The rules for ICD-10-CM documentation specificity work the same way in every category. The code is only as defensible as the note behind it.

Practices handling a steady volume of foot fractures get more from a structured note template than from coder training alone. With Pabau’s orthopedic claims management tools, you can build custom form templates that ask for displacement, laterality, and bone before the note is signed off.

Subsequent encounter codes for third metatarsal fractures

Most patients with a displaced third metatarsal fracture need several follow-up visits. Each visit after active treatment moves to a subsequent encounter code. The healing status documented at that visit decides which extension applies.

Rehabilitation usually runs alongside the orthopedic follow-ups. Look for physical therapy practice management platforms that carry the ICD-10 code into the treatment plan. The coding then stays consistent across the whole episode.

• S92.332D: Routine healing follow-up. The x-ray shows callus formation progressing normally, as at a standard cast check or a weight-bearing transition visit.
• S92.332G: Delayed healing. Imaging at 8 to 12 weeks shows inadequate callus formation and the provider documents slower progress than expected. This may prompt a bone stimulator referral.
• S92.332K: Nonunion confirmed. Fracture lines remain visible without bridging callus, typically beyond 4 to 6 months, and surgical options are worth discussing.
• S92.332P: Malunion. The fracture healed in an angulated or rotated position, and the patient presents with forefoot pain, deformity, or difficulty with footwear.
• S92.332S: Sequela. The fracture itself is resolved. What remains is a lasting condition, such as post-traumatic metatarsalgia or a bony prominence, that now brings the patient in.

Set against the healing timeline, the six extensions fall into three phases: Active treatment, follow-up, and late effect.

When sequela coding applies, code the sequela condition first and list S92.332S second. The external cause code for how the fracture happened also takes 7th character S where it applies. The AAPC ICD-10-CM lookup carries the full tabular context for sequela conventions under S92.

Related ICD-10-CM codes for metatarsal fractures

S92.332A sits within a structured family of metatarsal fracture codes. Knowing the adjacent codes helps you pick the most specific option available. It also gives you something to cross-check against when the laterality or the displacement status differs. The ICD List carries a free searchable tabular view of the full S92.3 subcategory.

The same habit pays off on any ICD-10 diagnostic code reference: Start at the subcategory, then work down to the billable seventh character.

CPT codes commonly billed with S92.332A

The CPT code you bill alongside S92.332A depends on the management approach chosen at the initial encounter. Get the pairing wrong and the claim stalls. Practices submitting through a medical claims clearinghouse get CPT-to-ICD-10 edit checks that flag a mismatched procedure and diagnosis before submission.

Verification note: The descriptions above reflect commonly cited pairings for closed metatarsal fracture treatment. Confirm each descriptor against the current AMA CPT manual before you submit, because descriptors and bundling rules change with the annual update. Pabau handles electronic claims via Claim.MD, with real-time payer eligibility checks and claim status tracking. A rejection shows up in the same dashboard you submitted from.

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

Knowing where S92.332A sits in the hierarchy speeds up parent-code lookups and crosswalk work. It also explains payer policies that bite at the category or subcategory level. The ResDAC ICD codes in Medicare data resource explains how these hierarchy levels appear in Medicare claims files.

1. S00-T88: Injury, poisoning, and certain other consequences of external causes (chapter)
2. S90-S99: Injuries to the ankle and foot (block)
3. S92: Fracture of foot and toe, except ankle (category)
4. S92.3: Fracture of metatarsal bone(s) (subcategory)
5. S92.33: Fracture of third metatarsal bone (group)
6. S92.332: Displaced fracture of third metatarsal bone, left foot (6-character base code)
7. S92.332A: Displaced fracture of third metatarsal bone, left foot, initial encounter for closed fracture (billable)

Clinical overview: Third metatarsal fractures

The third metatarsal sits in the middle of the forefoot column, between the second and fourth metatarsals. Fractures here typically follow a direct crush injury, repeated stress loading, or a twisting mechanism. Fifth metatarsal fractures turn on which zone the break falls in. Third metatarsal fractures turn on the degree of displacement and the patient’s activity demands.

• Common mechanisms: A dropped heavy object, a stumble or fall with forefoot impact, or a sports-related plantar flexion-inversion. Cumulative stress in athletes produces a stress fracture, which uses a different code family.
• Displacement significance: A displaced fracture has fragment separation or angulation by definition. That drives the choice between manipulation and observation, and it decides which ICD-10 code applies. The Ottawa ankle and foot rules help you decide which foot injuries warrant imaging, and imaging is what builds the documentation trail the code needs.
• Typical treatment: Closed reduction and immobilization handle most displaced third metatarsal fractures. Surgical fixation is reserved for significantly displaced or unstable patterns, polytrauma, and open injuries.
• Recovery timelines: Most closed displaced third metatarsal fractures heal within 6 to 8 weeks with proper immobilization. Delayed union and nonunion are less common here than at the fifth metatarsal. Where they do occur, the follow-up visit takes the G or K 7th character. Structured return-to-activity protocols are usually coordinated with physical therapy in the late healing phase.

ICD-9-CM crosswalk

Legacy billing systems, research databases, and payer correspondence sometimes require mapping S92.332A to its ICD-9-CM predecessor. The mapping is approximate. ICD-9-CM cannot represent laterality, displacement, or bone-level detail the way ICD-10-CM does. Sound medical billing workflows include knowing when a crosswalk approximation is appropriate and when it is not.

Important: The crosswalk above is approximate only, derived from CMS General Equivalence Mapping (GEM) conventions. Never assert it as a legally equivalent code for an audit, an appeal, or a legal matter. Verify the specific mapping against the current CMS GEM files before you rely on it.

Common coding errors to avoid

Displaced third metatarsal fractures generate a predictable set of coding mistakes. Specificity errors are a well-known cause of first-pass rejections on musculoskeletal codes, which is why denial management teams watch them closely. Catching one before submission is faster and cheaper than working the denial.

• Missing 7th character: Submitting S92.332 without the required 7th character. That is an invalid code, and it rejects at the clearinghouse or the payer edit stage.
• Wrong displacement code: Using S92.335A (nondisplaced, left foot) when the note and the imaging both confirm displacement. The two are not interchangeable, because nondisplaced fractures follow different treatment pathways and reimbursement logic.
• Wrong laterality: Assigning S92.331A (right foot) when the fracture is on the left. It is recoverable, but it costs a corrected claim and the administrative time to file it.
• Unspecified bone: Coding S92.30xA (fracture of unspecified metatarsal bone) when the note identifies the third metatarsal. Unspecified codes invite payer scrutiny and often prompt a documentation request.
• Incorrect encounter type: Using S92.332A for a routine cast-check visit where no management change occurred. That visit is S92.332D. The 7th character must reflect the encounter in front of you, rather than defaulting to A.
• Sequela confusion: Coding the original fracture at a visit where only a post-fracture complication, such as metatarsalgia, is being treated. Once the fracture has healed, the complication becomes the primary diagnosis and S92.332S goes second.

How Pabau supports fracture coding and claim submission

In most orthopedic practices the note lives in one system and the claim lives in another. A coder reads the note, picks S92.332A, and types it into a billing tool. Whatever the note left out gets discovered later, by the payer.

Pabau is practice management software that keeps both in the same record. The treatment note, the invoice, and the electronic claim all sit against the patient file. The coder reads the note the clinician wrote at the visit, rather than a summary of it.

You can build the note template around the four elements S92.332A needs. Displacement, laterality, bone, and encounter type each get their own field, so a half-documented note never reaches billing. In the US, claims then go out through Claim.MD, with real-time eligibility checks and claim status tracking in the same dashboard.

The payoff is fewer corrected claims, and less time spent chasing a missing qualifier three weeks after the visit.

Keep fracture coding and claims in one system

Pabau keeps the treatment note, the invoice, and the electronic claim against one patient record. Orthopedic and sports-medicine practices use it to submit claims through Claim.MD and track every one through to payment.

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Conclusion

The hard part of S92.332A is not finding the code. It is making sure the note says displaced, says left, says third metatarsal, and shows a treatment decision at this visit. Get those four into the template once and the code looks after itself.

The 7th character is where the ongoing work sits. Every follow-up is a fresh choice between D, G, K, P, and S, and it has to match what the imaging showed that day. Review a quarter of your own denials and you will usually find the same one or two extensions going out wrong. Fixing the template beats fixing the claims.

Pabau’s claims management software keeps the note, the invoice, and the claim against one patient record. The specificity you documented is then the specificity you bill. To see how that works across a multi-provider orthopedic practice, book a demo with our team.

Continue your research

Need to understand how clearinghouse submissions work for fracture claims? Pabau’s Claim.MD clearinghouse guide explains how electronic claim submission, payer edits, and ERA processing work end to end.

Want to reduce claim denials across your orthopedic billing team? Denial codes in medical billing covers the most common CARC and RARC denial patterns and how to address each one.

Looking for guidance on insurance eligibility verification before treatment? Insurance eligibility verification outlines how to check coverage and benefits before the patient’s initial fracture visit.

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