S32.616A vs S32.616D

S32.616A (Nondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture) compared with S32.616D (Nondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with routine healing), from the official CMS tabular data. S32.616A and S32.616D code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S32.616A

Initial encounter

Nondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture

↔

S32.616D

Subsequent encounter

Nondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with routine healing

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. S32.616A and S32.616D 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

	S32.616ANondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture	S32.616DNondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with routine healing
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	Nondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S32.616A).	Nondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S32.616D).
7th character	The appropriate 7th character is to be added to each code from category S32	The appropriate 7th character is to be added to each code from category S32
Includes	fracture of lumbosacral neural arch fracture of lumbosacral spinous process fracture of lumbosacral transverse process fracture of lumbosacral vertebra	fracture of lumbosacral neural arch fracture of lumbosacral spinous process fracture of lumbosacral transverse process fracture of lumbosacral vertebra
Code first	any associated spinal cord and spinal nerve injury (S34.-)	any associated spinal cord and spinal nerve injury (S34.-)

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