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S26.11XA vs S26.11XS

S26.11XA (Contusion of heart without hemopericardium, initial encounter) compared with S26.11XS (Contusion of heart without hemopericardium, sequela), from the official CMS tabular data. S26.11XA and S26.11XS code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S26.11XA
Initial encounter
Contusion of heart without hemopericardium, initial encounter
S26.11XS
Sequela
Contusion of heart without hemopericardium, sequela

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

Can these codes be reported together?

Same injury, other encounter phase. S26.11XA and S26.11XS 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.

Side by side

S26.11XAContusion of heart without hemopericardium, initial encounterS26.11XSContusion of heart without hemopericardium, sequela
Billing statusBillableBillable
ClassificationS00-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)
DefinitionContusion of heart without hemopericardium, initial encounter is a billable ICD-10-CM diagnosis code (S26.11A).Contusion of heart without hemopericardium, sequela is a billable ICD-10-CM diagnosis code (S26.11S).
7th characterThe appropriate 7th character is to be added to each code from category S26The 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
injuries of breast
injuries of chest (wall)
injuries of interscapular area

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources