{"id":183440,"date":"2026-08-18T11:37:40","date_gmt":"2026-08-18T11:37:40","guid":{"rendered":"https:\/\/pabau.com\/?p=183440"},"modified":"2026-08-18T11:37:43","modified_gmt":"2026-08-18T11:37:43","slug":"icd-10-code-s82499q","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/","title":{"rendered":"ICD-10 code S82.499Q: Fibula shaft fracture with malunion"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"ICD-10 code S82.499Q: Fibula shaft fracture with malunion\",\"description\":\"ICD-10 code S82.499Q (Other fracture of shaft of unspecified fibula, subsequent encounter for open fracture type I or II with malunion). Reference guide for coders and clinicians.\",\"url\":\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s82499q\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-01\",\"dateModified\":\"2026-08-18\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>S82.499Q covers a fibula shaft fracture that healed crooked after an open type I or II injury, billed at a subsequent encounter<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>In S82.499, unspecified describes the side, not the bone. The fibula is named, but the left or right is not<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The 7th character Q means open type I or II with malunion. Closed malunion takes P, and Gustilo type III malunion takes R<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Use S82.499 only when the side is genuinely undocumented. Prefer S82.491Q for the right fibula and S82.492Q for the left<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau keeps the note, the code, and the claim on one patient record<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">ICD-10-CM code S82.499Q reports other fracture of the shaft of the unspecified fibula. The 7th character Q carries the rest. It marks a subsequent encounter for an open type I or II fracture that healed with malunion.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In plain terms, the fibula shaft broke, a small or moderate wound opened the skin, and the bone united out of position. The code is billable, so it can carry a claim on its own.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One word in that descriptor causes most of the errors. Unspecified points at the side of the body, not at the bone. S82.499 always names the fibula, whichever side is involved.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The tables below cover the official description, the code hierarchy, and the full 7th character set for S82.499. They also show which Gustilo types push you to R instead of Q, plus what the note must say before a claim goes out.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"ICD-10 Revisions: Stay Updated or Fall Behind\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/bqAyb-BCA0w?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-icd-10-code-s82-499q-definition-and-official-description\" class=\"wp-block-heading\">ICD-10 code S82.499Q: Definition and official description<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">ICD-10 Code S82.499Q is a valid, billable ICD-10-CM diagnosis code. According to the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/icd-10-codes\" target=\"_blank\" rel=\"nofollow noopener\">CMS ICD-10-CM code files<\/a>, its full official description is:<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:140px\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82.499Q<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of unspecified fibula, subsequent encounter for open fracture type I or II with malunion<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code system<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes \u2014 valid for HIPAA-covered transactions<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Episode of care<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter (7th character Q)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Applicable fracture type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open fracture, Gustilo type I or II<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Complication<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malunion (healed in non-anatomic position)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Laterality<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified fibula \u2014 use only when the side is genuinely undocumented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anatomical site<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Shaft of the fibula, the thinner of the two lower leg bones<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/icd10cmtool.cdc.gov\/\" target=\"_blank\" rel=\"nofollow noopener\">CDC\/NCHS ICD-10-CM web tool<\/a> confirms this code is active for the current fiscal year. Verify that annually, because CMS releases updated code files each October. The same category-to-7th-character path runs through neighboring lower-limb codes such as <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s72309n\/\">S72.309N<\/a>.<\/p>\n\n\n\n<h2 id=\"h-code-hierarchy-and-parent-codes\" class=\"wp-block-heading\">Code hierarchy and parent codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">S82.499Q sits at the end of a precise hierarchical path within ICD-10-CM Chapter 19 (Injury, Poisoning and Certain Other Consequences of External Causes). Each level narrows the anatomical and clinical specificity.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:140px\">Code level<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Category<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of lower leg, including ankle<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Subcategory<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82.4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of shaft of fibula<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Subcategory<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82.49<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of fibula<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82.499<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of unspecified fibula (requires 7th character)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S82.499Q<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of unspecified fibula, subsequent encounter for open fracture type I or II with malunion<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The \u00ab\u00a0other\u00a0\u00bb designation at S82.49 means the fracture pattern is not one of the named patterns under S82.4. Those named options are transverse (S82.42), oblique (S82.43), spiral (S82.44), comminuted (S82.45), and segmental (S82.46). Work through them before you settle on S82.499Q.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A second trap sits nearby. S82.90 reads \u00ab\u00a0unspecified fracture of unspecified lower leg\u00a0\u00bb, and that code names no bone at all. Reach for it only when the record does not say which bone broke.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Platforms that build ICD-10-CM lookup into the note help here. A <a href=\"https:\/\/pabau.com\/industry\/physical-therapy-emr\/\">physical therapy EMR<\/a> that searches by keyword surfaces the candidates side by side. The most specific code then wins before the claim leaves.<\/p>\n\n\n\n<h2 id=\"h-understanding-the-7th-character-q\" class=\"wp-block-heading\">Understanding the 7th character Q<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 7th character is where most coding errors occur with fibula shaft fracture codes. For S82.499, 16 extensions apply. Each one encodes both the episode of care and the fracture&rsquo;s healing status. The table below shows the complete set, as defined in the ICD-10-CM Official Guidelines for Coding and Reporting.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:60px\">7th character<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical meaning<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:center;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Episode<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Initial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">B<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial encounter for open fracture type I or II<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Initial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial encounter for open fracture type IIIA, IIIB, or IIIC<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Initial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for closed fracture with routine healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with routine healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">F<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for closed fracture with delayed healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">H<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with delayed healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">K<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for closed fracture with nonunion<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with nonunion<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for closed fracture with malunion<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><strong>Q<\/strong><\/td>\n<td style=\"padding:12px 16px;color:#374151\"><strong>Subsequent encounter for open fracture type I or II with malunion<\/strong><\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\"><strong>Subsequent<\/strong><\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">R<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Subsequent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sequela<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Sequela<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Three 7th character errors account for most denials in this code family:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Using Q when the original fracture was closed. P applies instead.<\/li>\n\n\n\n<li>Using Q when the original fracture was Gustilo type IIIA, IIIB, or IIIC. R is correct.<\/li>\n\n\n\n<li>Using A or B on a return visit, after active treatment has ended.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The guidelines define a subsequent encounter narrowly. It is any encounter after active treatment is complete, while the patient receives routine care during healing or recovery. The same qualifier logic separates routine healing from a complication in codes like <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s72036e\/\">S72.036E<\/a>.<\/p>\n\n\n\n<h2 id=\"h-clinical-context-when-to-use-s82-499q\" class=\"wp-block-heading\">Clinical context: When to use S82.499Q<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Three conditions must all be true before S82.499Q is appropriate. Document each one clearly in the clinical note before submitting the claim.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Open fracture, type I or II:<\/strong> The original injury broke through the skin. Type I and II sit at the low-energy, cleaner end of the Gustilo-Anderson scale, and the table below gives the wound sizes. Higher-energy type III fractures take different 7th characters.<\/li>\n\n\n\n<li><strong>Malunion documented:<\/strong> Imaging or clinical examination confirms the fracture has healed in a non-anatomic position. Malunion is not the same as delayed healing (H) or nonunion (M\/K). If the fracture has not yet healed, use the delayed healing or nonunion characters instead.<\/li>\n\n\n\n<li><strong>Subsequent encounter:<\/strong> The patient has completed active fracture treatment and is presenting for follow-up care, rehabilitation, or management of the malunion complication. The treating provider is no longer managing an acute fracture.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Orthopedic and <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine software<\/a> platforms that embed ICD-10-CM lookups can surface this code while the note is being written. That timing is what stops the wrong episode-of-care character reaching a repeat visit.<\/p>\n\n\n\n<h3 id=\"h-how-the-gustilo-type-decides-between-q-and-r\" class=\"wp-block-heading\">How the Gustilo type decides between Q and R<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The Gustilo-Anderson system is the reference standard for open fracture classification in orthopedic coding. Wound size and contamination decide the type, and the type decides whether malunion takes Q or R.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:100px\">Gustilo type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Wound characteristics<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Relevant ICD-10-CM 7th characters (malunion)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type I<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Wound less than 1 cm, low energy, clean wound, minimal soft tissue damage<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Q (malunion subsequent)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type II<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Wound 1 to 10 cm, moderate contamination, moderate soft tissue damage<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Q (malunion subsequent)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type IIIA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High energy, wound greater than 10 cm, adequate soft tissue coverage possible<\/td>\n<td style=\"padding:12px 16px;color:#374151\">R (malunion subsequent)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type IIIB<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High energy, extensive soft tissue loss, periosteal stripping, bone exposure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">R (malunion subsequent)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type IIIC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Any open fracture with arterial injury requiring repair<\/td>\n<td style=\"padding:12px 16px;color:#374151\">R (malunion subsequent)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Check how the original operative or emergency department note classified the fracture. If it was type IIIA, IIIB, or IIIC, a subsequent encounter with malunion takes S82.499R rather than S82.499Q. When the original Gustilo type is not documented, query the treating physician before selecting Q or R.<\/p>\n\n\n\n<h2 id=\"h-coding-guidelines-and-billing-considerations\" class=\"wp-block-heading\">Coding guidelines and billing considerations<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Several ICD-10-CM Official Guidelines sections directly affect how S82.499Q is reported. Skipping them is a frequent reason fracture claims get flagged on audit, and the wider rules on <a href=\"https:\/\/pabau.com\/blog\/medical-billing-compliance\/\">medical billing compliance<\/a> apply on top.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau records the diagnosis code on the encounter itself. The same record then carries through to the claim, so the note and the bill never drift apart.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-s82499q\/automate-claims-through-healthcode.webp\" alt=\"Insurer invoice raised at checkout in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau raises the insurer invoice at checkout, so the follow-up visit is billed from the same record that holds the code.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 id=\"h-laterality-when-unspecified-applies\" class=\"wp-block-heading\">Laterality: When \u00ab\u00a0unspecified\u00a0\u00bb applies<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">S82.499Q specifies an unspecified fibula, and that should be a last resort. Use it only when the provider&rsquo;s documentation does not identify the left or right side. In practice, that is rare on a follow-up visit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The specific alternatives are S82.491Q for the right fibula and S82.492Q for the left. Both accept the same 7th character extensions. Defaulting to unspecified when the side is documented is under-coding, and it weakens the record for any later audit.<\/p>\n\n\n\n<h3 id=\"h-documentation-requirements-for-malunion\" class=\"wp-block-heading\">Documentation requirements for malunion<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Malunion must be explicitly documented by the treating clinician. Coders cannot infer malunion from imaging reports alone. The clinical note should state that the fracture has healed in a non-anatomic or malaligned position, or use equivalent clinical terminology.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">digital clinical forms<\/a> let practices build structured follow-up templates. Each template can prompt the provider for healing status, the Gustilo type from the original injury, and the side.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reduces incomplete documentation before claims reach the payer. A <a href=\"https:\/\/pabau.com\/blog\/medical-chart-audit\/\">medical chart audit<\/a> tests the same three details, so a template that captures them holds up under review.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-s82499q\/digital-forms.webp\" alt=\"Building a medical form template in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Form templates let you build a fracture follow-up questionnaire that asks for union status, Gustilo type, and side.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 id=\"h-sequencing-and-external-cause-codes\" class=\"wp-block-heading\">Sequencing and external cause codes<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">S82.499Q should be the principal diagnosis when malunion is the primary reason for the encounter. If the patient is admitted for a related procedure, such as corrective osteotomy, the procedure code drives the inpatient payment group. The malunion code still leads the diagnosis list.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">An external cause code from the V, W, X, or Y categories is not required for subsequent encounters. Many payers and trauma registries still expect one for audit completeness. Check the place-of-service code too, since malunion follow-ups usually happen in an outpatient office rather than an inpatient setting.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a quarterly audit on every S82.499 claim from the prior 90 days. Check two things on each one. The operative or emergency department note confirms Gustilo type I or II, and the episode qualifier moved off A or B when active treatment ended. Mismatched qualifiers are the top trigger for medical necessity denials on subsequent-encounter fracture claims.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-related-and-adjacent-icd-10-codes\" class=\"wp-block-heading\">Related and adjacent ICD-10 codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">S82.499Q has sibling and parent codes that coders meet in the same fracture management context. Picking the wrong one is a recurring audit finding on fibula shaft fracture claims. The <a href=\"https:\/\/www.aapc.com\/codes\/icd-10-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC ICD-10-CM lookup<\/a> tool lets coders browse the full S82.499 family side by side before finalizing a claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Working through a code family this way is a habit worth keeping. Malunion coding turns on the same question in other regions of the body, as <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s49109p\/\">S49.109P<\/a> shows.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:120px\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction from S82.499Q<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499B<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of unspecified fibula, initial encounter for open fracture type I or II<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial encounter \u2014 active treatment in progress<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499E<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with routine healing<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Healing normally \u2014 no complication<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499H<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with delayed healing<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Healing is slow but has not yet concluded in malunion or nonunion<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499M<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with nonunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture has not united \u2014 no bony healing has occurred<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499P<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for closed fracture with malunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malunion, but original fracture was closed rather than open<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499Q<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type I or II with malunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">This code<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499R<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malunion, but original fracture was Gustilo type III<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.499S<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of unspecified fibula, sequela<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Late effects \u2014 used after healing is complete and a residual condition persists<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.491Q<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of right fibula, subsequent encounter for open fracture type I or II with malunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right fibula identified \u2014 preferred when the side is known<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.492Q<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other fracture of shaft of left fibula, subsequent encounter for open fracture type I or II with malunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left fibula identified \u2014 preferred when the side is known<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S82.90<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified fracture of unspecified lower leg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Names no bone at all \u2014 not a substitute when the fibula is documented<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The M versus Q distinction matters clinically as well as financially. Nonunion (M) means the bone ends never bridged. Malunion (Q) means the fracture did unite, but in a poor position. Each one leads to different management and different procedural codes if corrective surgery follows.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Templated follow-up notes cut the risk of mixing them up. <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">Patient record documentation<\/a> in Pabau can prompt the clinician to record healing status at every visit.<\/p>\n\n\n\n<h2 id=\"h-how-pabau-keeps-fibula-fracture-coding-tied-to-the-claim\" class=\"wp-block-heading\">How Pabau keeps fibula fracture coding tied to the claim<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most practices split this work across two systems. The clinician writes the follow-up note in one place, and a biller re-keys the diagnosis into a claim somewhere else. Every re-key is a chance for the wrong 7th character to reach the payer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau keeps both halves on one patient record. The treatment note, the imaging that confirmed malunion, and the form that captured the side all sit on the same chart. Billing then works from what the clinician actually wrote.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">Pabau&rsquo;s claims management software<\/a> runs validation checks each time you send a claim, so missing membership numbers or authorization codes surface before submission. US practices submit through Claim.MD and can run real-time eligibility checks. Every claim shows its live status, and payment is recorded against the right invoice in the same dashboard.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Documentation is the other half of the problem, because a coder can only work with what was written down. <a href=\"https:\/\/pabau.com\/features\/ai-medical-scribe\/\">Pabau Scribe<\/a>, our AI scribe, drafts the consultation note as the appointment happens. A malunion follow-up note has to confirm union, describe the malalignment, and name the side.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For an orthopedic or physical therapy practice, that means fewer claims returned for missing information. It also means a record that holds up when a payer asks how the malunion was confirmed.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-s82499q\/comprehensive-emr-patient-record-management.webp\" alt=\"Sharing a treatment note from the patient record in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>A saved treatment note can be shared with the referring physician or the payer, so the malunion record travels with the claim.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep fibula fracture coding and claims in one record                <\/h3>\n\n                <p class=\"description\">\n                    Pabau holds the treatment note, the forms, and the claim on the same patient record. Validation checks run before every submission, so subsequent-encounter claims leave with the detail payers ask for.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">S82.499Q rewards the coder who reads the original injury note, not only the follow-up. The Gustilo type and the open-or-closed call were both made months earlier. Those two details decide whether this visit takes P, Q, or R.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Treat unspecified laterality as a prompt rather than a default. If the side appears anywhere in the chart, S82.491Q or S82.492Q makes the stronger claim. Payers read it the same way on review.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What holds all of this together is a record the biller can trust. <a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">Practice management software<\/a> keeps the note, the imaging, and the claim on one chart. To see how your team could document a malunion follow-up and bill it from that record, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Assessing a lower-limb injury before you code it?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/pittsburgh-knee-rules\/\">Pittsburgh Knee Rules<\/a> gives the criteria and walk test that decide whether imaging is needed.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Documenting an orthopedic exam finding?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/neers-test\/\">Neer\u2019s test<\/a> sets out how to perform it and how to record the result.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing the surgery that follows a malunion?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20690\/\">CPT code 20690<\/a> covers external fixation and what the operative note has to support.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a late effect instead of active care?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s72124s\/\">S72.124S<\/a> shows how the sequela extension changes what the claim reports.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Losing revenue to fracture claim denials?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/denial-management-in-healthcare\/\">Denial management<\/a> explains how practices track, appeal, and prevent rejected claims.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1787040164987\"><h3 class=\"schema-faq-question\">What does ICD-10 code S82.499Q mean?<\/h3> <p class=\"schema-faq-answer\">ICD-10 code S82.499Q means \u00ab\u00a0other fracture of shaft of unspecified fibula, subsequent encounter for open fracture type I or II with malunion.\u00a0\u00bb It is billable. Use it when a patient returns for follow-up after an open fibula shaft fracture, type I or II, that healed out of position.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787040164988\"><h3 class=\"schema-faq-question\">What is the 7th character Q in ICD-10 fracture codes?<\/h3> <p class=\"schema-faq-answer\">The 7th character Q denotes a subsequent encounter for an open fracture of Gustilo type I or II that has resulted in malunion. It distinguishes this scenario from nonunion (M), delayed healing (H), routine healing (E), and type III open fractures with malunion (R).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787040164989\"><h3 class=\"schema-faq-question\">What is the difference between S82.499Q and S82.499M?<\/h3> <p class=\"schema-faq-answer\">S82.499M is used when the fracture has not healed at all (nonunion), meaning bone bridging has failed to occur. S82.499Q is used when the fracture has healed but in a mechanically or cosmetically suboptimal position (malunion). Both require distinct clinical documentation and often different procedural interventions.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787040164990\"><h3 class=\"schema-faq-question\">Is S82.499Q billable?<\/h3> <p class=\"schema-faq-answer\">Yes, S82.499Q is a valid and billable ICD-10-CM diagnosis code for HIPAA-covered transactions. It is active in the current fiscal year code set per CMS. Verify its active status annually when CMS releases updated ICD-10-CM files each October.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787040164991\"><h3 class=\"schema-faq-question\">When should I use S82.499Q instead of S82.491Q or S82.492Q?<\/h3> <p class=\"schema-faq-answer\">Use S82.499Q only when the provider&rsquo;s documentation does not identify which fibula was fractured. S82.491Q (right fibula) and S82.492Q (left fibula) are preferred whenever the side is documented. Defaulting to unspecified when the side is known is under-coding.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787040164992\"><h3 class=\"schema-faq-question\">How is a fibula shaft fracture with malunion coded in ICD-10-CM?<\/h3> <p class=\"schema-faq-answer\">Start from the base code for the fracture pattern and the side. For another fibula shaft fracture with no side documented, that base is S82.499. Then append the 7th character that matches the original injury. Closed with malunion takes P, open type I or II takes Q, and open type IIIA, IIIB, or IIIC takes R.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>ICD-10-CM code S82.499Q reports other fracture of the shaft of the unspecified fibula. The 7th character Q carries the rest. It marks a subsequent encounter for an open type I or II fracture that healed with malunion. In plain terms, the fibula shaft broke, a small or moderate wound opened the skin, and the bone [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":183439,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"77","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1549,1550],"tags":[2775,1305,1666,3271],"class_list":["post-183440","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-diagnostic-codes","category-icd-10-cm","tag-fracture-management","tag-icd-10-codes","tag-orthopedic-billing","tag-orthopedic-trauma"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>ICD-10 code S82.499Q: Fibula shaft malunion (Q vs P or R)<\/title>\n<meta name=\"description\" content=\"S82.499Q covers a fibula shaft fracture that healed with malunion after an open type I or II injury. Coding and documentation rules.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICD-10 code S82.499Q: Fibula shaft malunion (Q vs P or R)\" \/>\n<meta property=\"og:description\" content=\"S82.499Q covers a fibula shaft fracture that healed with malunion after an open type I or II injury. Coding and documentation rules.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-18T11:37:40+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-18T11:37:43+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/icd-10-code-s82499q.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Maja Popovska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Maja Popovska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/\"},\"author\":{\"name\":\"Maja Popovska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/b00aec1dd379f0ddcf6137d78e2a21db\"},\"headline\":\"ICD-10 code S82.499Q: Fibula shaft fracture with malunion\",\"datePublished\":\"2026-08-18T11:37:40+00:00\",\"dateModified\":\"2026-08-18T11:37:43+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/\"},\"wordCount\":2734,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/icd-10-code-s82499q.webp\",\"keywords\":[\"Fracture management\",\"ICD-10 codes\",\"Orthopedic Billing\",\"Orthopedic trauma\"],\"articleSection\":[\"Diagnostic Codes\",\"ICD-10-CM\"],\"inLanguage\":\"fr-FR\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/\",\"name\":\"ICD-10 code S82.499Q: Fibula shaft malunion (Q vs P or R)\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/icd-10-code-s82499q.webp\",\"datePublished\":\"2026-08-18T11:37:40+00:00\",\"dateModified\":\"2026-08-18T11:37:43+00:00\",\"description\":\"S82.499Q covers a fibula shaft fracture that healed with malunion after an open type I or II injury. 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It distinguishes this scenario from nonunion (M), delayed healing (H), routine healing (E), and type III open fractures with malunion (R).\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#faq-question-1787040164989\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/diagnostic-codes\\\/icd-10-code-s82499q\\\/#faq-question-1787040164989\",\"name\":\"What is the difference between S82.499Q and S82.499M?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"S82.499M is used when the fracture has not healed at all (nonunion), meaning bone bridging has failed to occur. S82.499Q is used when the fracture has healed but in a mechanically or cosmetically suboptimal position (malunion). 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Use it when a patient returns for follow-up after an open fibula shaft fracture, type I or II, that healed out of position.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164988","position":2,"url":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164988","name":"What is the 7th character Q in ICD-10 fracture codes?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The 7th character Q denotes a subsequent encounter for an open fracture of Gustilo type I or II that has resulted in malunion. It distinguishes this scenario from nonunion (M), delayed healing (H), routine healing (E), and type III open fractures with malunion (R).","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164989","position":3,"url":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164989","name":"What is the difference between S82.499Q and S82.499M?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"S82.499M is used when the fracture has not healed at all (nonunion), meaning bone bridging has failed to occur. S82.499Q is used when the fracture has healed but in a mechanically or cosmetically suboptimal position (malunion). Both require distinct clinical documentation and often different procedural interventions.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164990","position":4,"url":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164990","name":"Is S82.499Q billable?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes, S82.499Q is a valid and billable ICD-10-CM diagnosis code for HIPAA-covered transactions. It is active in the current fiscal year code set per CMS. Verify its active status annually when CMS releases updated ICD-10-CM files each October.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164991","position":5,"url":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164991","name":"When should I use S82.499Q instead of S82.491Q or S82.492Q?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Use S82.499Q only when the provider's documentation does not identify which fibula was fractured. S82.491Q (right fibula) and S82.492Q (left fibula) are preferred whenever the side is documented. Defaulting to unspecified when the side is known is under-coding.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164992","position":6,"url":"https:\/\/pabau.com\/fr\/diagnostic-codes\/icd-10-code-s82499q\/#faq-question-1787040164992","name":"How is a fibula shaft fracture with malunion coded in ICD-10-CM?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Start from the base code for the fracture pattern and the side. For another fibula shaft fracture with no side documented, that base is S82.499. Then append the 7th character that matches the original injury. Closed with malunion takes P, open type I or II takes Q, and open type IIIA, IIIB, or IIIC takes R.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"ICD-10 code S82.499Q","seo_title":"ICD-10 code S82.499Q: Fibula shaft malunion (Q vs P or R)","meta_description":"S82.499Q covers a fibula shaft fracture that healed with malunion after an open type I or II injury. Coding and documentation rules.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"lower leg fracture malunion icd 10","score":56},{"keyword":"unspecified lower leg fracture icd 10","score":56},{"keyword":"fall icd 10 code","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/183440","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/comments?post=183440"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/183440\/revisions"}],"predecessor-version":[{"id":183723,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/183440\/revisions\/183723"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media\/183439"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media?parent=183440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/categories?post=183440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/tags?post=183440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}