S26.020A (Mild laceration of heart with hemopericardium, initial encounter) compared with S26.020D (Mild laceration of heart with hemopericardium, subsequent encounter), from the official CMS tabular data. S26.020A and S26.020D code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S26.020A and S26.020D code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| S26.020AMild laceration of heart with hemopericardium, initial encounter | S26.020DMild laceration of heart with hemopericardium, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Mild laceration of heart with hemopericardium, initial encounter is a billable ICD-10-CM diagnosis code (S26.020A). | Mild laceration of heart with hemopericardium, subsequent encounter is a billable ICD-10-CM diagnosis code (S26.020D). |
| 7th character | The appropriate 7th character is to be added to each code from category S26 | The appropriate 7th character is to be added to each code from category S26 |
| Includes | injuries of breast injuries of chest (wall) injuries of interscapular area Laceration of heart without penetration of heart chamber | injuries of breast injuries of chest (wall) injuries of interscapular area Laceration of heart without penetration of heart chamber |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources