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S26.12XA vs S26.12XS

S26.12XA (Laceration of heart without hemopericardium, initial encounter) compared with S26.12XS (Laceration of heart without hemopericardium, sequela), from the official CMS tabular data. S26.12XA and S26.12XS code the same injury at a different phase of treatment.

Can these codes be reported together?

Same injury, other encounter phase. S26.12XA and S26.12XS 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

S26.12XALaceration of heart without hemopericardium, initial encounterS26.12XSLaceration 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)
DefinitionLaceration of heart without hemopericardium, initial encounter is a billable ICD-10-CM diagnosis code (S26.12A).Laceration of heart without hemopericardium, sequela is a billable ICD-10-CM diagnosis code (S26.12S).
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