ICD-10 Code S92.811B: Other fracture of right foot, open

Key takeaways

ICD-10 Code S92.811B covers an other fracture of the right foot, initial encounter for open fracture. It is valid for FY2026, October 1, 2025 through September 30, 2026.

The 7th character B is mandatory, and it designates an initial encounter for an open fracture only. Using B for a closed fracture is a coding error.

S92.811B is a billable, specific ICD-10-CM code inside the S92.8 subcategory. Its approximate ICD-9-CM equivalent is 825.39, other fracture of tarsal and metatarsal bones, open.

Pabau’s claims software submits S92.811B and its paired CPT codes electronically through the Claim.MD clearinghouse, which reaches thousands of US payers.

ICD-10 Code S92.811B identifies an other fracture of the right foot at the initial encounter for an open fracture. It is a billable, specific ICD-10-CM diagnosis code.

The code is valid from October 1, 2025 through September 30, 2026. It belongs to the FY2026 code set maintained by the Centers for Medicare and Medicaid Services and the National Center for Health Statistics.

The “other fracture” designation captures right foot fractures that do not fit a more specific S92 subcategory. A documented calcaneus or talus fracture, for example, has its own code. Open fracture status and right-side laterality are both encoded within the full seven-character code string.

Coders apply S92.811B only when the provider’s documentation confirms an open wound at the fracture site on the right foot. It also has to be the first encounter for active treatment.

Code details and classification

S92.811B sits within the ICD-10-CM chapter covering injury, poisoning, and certain other consequences of external causes (S00-T88). The full hierarchy runs from chapter down to the specific seven-character code. Each segment helps coders verify placement and avoid rejections tied to an incomplete code string.

• S00-T88: Injury, poisoning and certain other consequences of external causes (chapter-level)
• S90-S99: Injuries to the ankle and foot (block-level)
• S92: Fracture of foot and toe, excluding fracture of ankle (category)
• S92.8: Other fracture of foot (subcategory)
• S92.81: Other fracture of foot, unspecified laterality (five-character code)
• S92.811: Other fracture of right foot (six-character code)
• S92.811B: Other fracture of right foot, initial encounter for open fracture (billable seven-character code)

Read from the top down, every character added to the string narrows the diagnosis further. The last two do the work a payer scrutinizes most.

The S92 category excludes fractures of the ankle, which code to S82. Confirm the fracture sits in the foot rather than the ankle joint before assigning any S92 code.

How the 7th character B works

Character B designates the initial encounter for an open fracture, and it carries no other meaning. The 7th character is not optional on fracture codes in category S92. Applying the wrong one is a coding error that can trigger a denial or an audit flag.

“Initial encounter” means the patient is receiving active treatment for the condition. That is typically the first visit to an emergency department or an orthopedic surgeon.

“Open fracture” means the bone has broken through the skin, or an open wound communicates with the fracture site. The treating provider must document both conditions before a coder can select B.

A common error is using B at follow-up visits when the fracture was correctly coded B at the initial encounter. Subsequent visits use D for routine healing, G for delayed healing, K for nonunion, or P for malunion. The provider’s documented healing status decides which one applies.

Approximate synonyms and alternate descriptions

Several clinical terms appear interchangeably with the S92.811B code description in provider documentation and electronic health records. Recognizing these synonyms helps coders map the right diagnosis to the right code without requesting an unnecessary clarification addendum.

• Other fracture of right foot, open, initial encounter
• Open fracture of right foot (other), first visit
• Right foot fracture (other type), open wound, initial care
• Compound fracture of right foot, unspecified type, initial encounter
• Non-specific right foot fracture, open, first active treatment
• Other right foot fracture with open wound, initial encounter

Note that “compound fracture” is a lay synonym for open fracture in common clinical use. When provider notes use this term alongside right foot laterality and an initial encounter date, S92.811B is the appropriate assignment.

Related ICD-10 codes in the S92.811 family

S92.811B belongs to a tightly defined family of sibling codes, all of them inside the wider ICD-10-CM code library. The table below covers the complete S92.811 group plus the left-foot equivalents in S92.812. Compare them whenever you are verifying laterality on a bilateral injury claim.

When both feet are fractured in the same event, report both codes. S92.811B covers the right foot, and S92.812B covers the left. Sequencing follows the ICD-10-CM injury coding guidelines. Sequence the code for the most severe condition first, as the provider documented it.

You can verify a sibling code’s current description with the AAPC ICD-10-CM lookup tool before the claim goes out.

ICD-9-CM crosswalk for S92.811B

Practices running legacy billing systems or reconciling historical claims need an approximate ICD-9-CM mapping. ICD-9-CM used less granular laterality and fracture-type distinctions than ICD-10-CM. No one-to-one equivalent exists, so treat the crosswalk below as a guide rather than a rule.

The ICD-9 code 825.39 did not distinguish right versus left laterality. When converting legacy claims, note which foot was involved. Then confirm the payer’s crosswalk logic accepts the approximate mapping. Do not treat this as an exact equivalent for clinical or audit purposes.

Coding guidelines and clinical notes

Several ICD-10-CM Official Guidelines for Coding and Reporting rules affect how S92.811B is applied. Coders should review Section I.C.19.c, Coding of Traumatic Fractures, before assigning any fracture code in category S92.

• 7th character is mandatory. S92.811 without a 7th character is not billable. Claims submitted with an incomplete code string are rejected at the clearinghouse level.
• Open fracture documentation required. The provider must document “open fracture,” “open wound communicating with fracture,” or “compound fracture” in the initial visit note. Coder inference is not acceptable.
• Diagnosis authority. Only the treating provider’s documented diagnosis drives code selection. Coders do not independently determine fracture type or open status from imaging reports alone.
• Principal diagnosis sequencing. When S92.811B is the reason for the encounter, sequence it as the principal diagnosis. If the open fracture is a secondary finding, sequence it after the primary condition.
• External cause codes. Assign an external cause code from the V, W, X, or Y series to report the mechanism of injury. A fall from height or a motor vehicle collision are typical examples.
• S92 excludes note. S92 excludes fracture of the ankle, which codes to S82. Confirm the anatomical location is the foot, not the ankle mortise, before applying S92.811B.

Coding teams should read both the tabular list and the ICD-10-CM Official Guidelines before assigning a fracture code. Orthopedic denial management work frequently traces back to 7th character errors on S92 codes, which makes a periodic audit of these claims worthwhile. The full official guidelines are available through the CDC ICD-10-CM web tool.

Common CPT codes used with S92.811B

Open fractures of the right foot usually require surgical or procedural treatment. The CPT codes paired with S92.811B depend on what the surgeon documented and performed. The table below reflects common pairings in orthopedic and emergency settings. CPT selection must match the documented procedure, never the diagnosis code.

These pairings reflect common clinical contexts, not a promise of payment. Actual code selection depends on the documented procedure and the payer’s policy.

How Pabau keeps open fracture claims clean

In most orthopedic billing teams, the 7th character gets checked by hand. A coder opens the operative note and confirms the fracture was open. Then they type S92.811B into a claim form that carries no link back to the encounter.

Pabau, practice management software for medical and aesthetic practices, includes claims software for practices that pairs the diagnosis with the procedure inside the patient record. Built-in ICD-10 and CPT catalogs mean a coder picks S92.811B from the same screen that holds the note. Eligibility checks run in real time, before the claim leaves the practice.

Claims then submit electronically through the Claim.MD clearinghouse, which reaches thousands of US payers. So a 7th character mismatch surfaces while the coder still has the chart open, rather than six weeks later on a remittance advice.

Pair every fracture code with the right procedure

Pabau’s claims tools hold the ICD-10 and CPT catalogs inside the patient record, run eligibility checks before submission, and route claims through the Claim.MD clearinghouse. Coders catch 7th character errors before a payer does.

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Conclusion

Open fracture claims get denied for a short list of reasons. The 7th character is wrong, or the encounter type changed without a code update. The third reason is a paired CPT code that does not match the operative note.

S92.811B is precise and billable, but only when the provider’s note confirms an open fracture of the right foot. That confirmation has to sit in the initial-encounter note. Every subsequent visit then requires a different 7th character.

Audit a month of S92.811B claims against the operative notes behind them, and you will find the 7th character errors before a payer does. Book a demo to see how Pabau pairs the diagnosis and the procedure before a trauma claim goes out.

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