S92.514B: Nondisplaced fracture of proximal phalanx of right lesser toe(s), initial encounter for open fracture

S92.514B, nondisplaced fracture of proximal phalanx of right lesser toe(s), initial encounter for open fracture, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 20 HCPCS Level II codes, including G0008 (Administration of influenza virus vaccine), G0009 (Administration of pneumococcal vaccine), G0010 (Administration of hepatitis b vaccine). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with S92.514B as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0008Administration of influenza virus vaccineCarrier judgment—1
G0009Administration of pneumococcal vaccineCarrier judgment—1
G0010Administration of hepatitis b vaccineCarrier judgment—1
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)Special coverage instructions apply—1
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)Special coverage instructions apply—1
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)Special coverage instructions apply—1
Q2034Influenza virus vaccine, split virus, for intramuscular use (agriflu)Special coverage instructions apply—1
Q2036Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)Special coverage instructions apply—1
Q2039Influenza virus vaccine, not otherwise specifiedSpecial coverage instructions apply—1
G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesCarrier judgment—2
G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of careCarrier judgment—2
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—1
G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2250Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of careCarrier judgment—1
G2251Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussionCarrier judgment—1
G0157Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0159Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutesCarrier judgment—1
G2168Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutesCarrier judgment—1
L1972Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelfCarrier judgment—1

Medicare policy articles listing S92.514B

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other S92 diagnoses (Fracture of foot and toe, except ankle)

Frequently asked questions

Does Medicare cover S92.514B (Nondisplaced fracture of proximal phalanx of right lesser…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S92.514B as a covered diagnosis for 20 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 S92.514B?

The Level II codes from the policies most specific to this diagnosis are G0008 (Administration of influenza virus vaccine, 1 article); G0009 (Administration of pneumococcal vaccine, 1 article); G0010 (Administration of hepatitis b vaccine, 1 article); Q2038 (Influenza virus vaccine, split virus, when administered to…, 1 article); Q2035 (Influenza virus vaccine, split virus, when administered to…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list S92.514B?

A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines); A57311 (Billing and Coding: Physical Therapy - Home Health); A53058 (Billing and Coding: Home Health Physical Therapy).

What is ICD-10-CM code S92.514B?

S92.514B is the ICD-10-CM code for nondisplaced fracture of proximal phalanx of right lesser toe(s), initial encounter for open fracture, in category S92 (Fracture of foot and toe, except ankle), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Compiled by Caduvo from public CMS (Medicare) records, ICD-10-CM FY2026, HCPCS release October 2026, 2026 fee schedule (non-rural state fees). Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup