S26.021A (Moderate laceration of heart with hemopericardium, initial encounter) compared with S26.021S (Moderate laceration of heart with hemopericardium, sequela), from the official CMS tabular data. S26.021A and S26.021S 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. S26.021A and S26.021S 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.
| S26.021AModerate laceration of heart with hemopericardium, initial encounter | S26.021SModerate laceration of heart with hemopericardium, sequela | |
|---|---|---|
| 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 | Moderate laceration of heart with hemopericardium, initial encounter is a billable ICD-10-CM diagnosis code (S26.021A). | Moderate laceration of heart with hemopericardium, sequela is a billable ICD-10-CM diagnosis code (S26.021S). |
| 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 with penetration of heart chamber | injuries of breast injuries of chest (wall) injuries of interscapular area Laceration of heart with 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