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S48.111A vs S48.111S

S48.111A (Complete traumatic amputation at level between right shoulder and elbow, initial encounter) compared with S48.111S (Complete traumatic amputation at level between right shoulder and elbow, sequela), from the official CMS tabular data. S48.111A and S48.111S code the same injury at a different phase of treatment. MedCoder-derived

Can these codes be reported together?

Review

Encounter relationship

S48.111A
Initial encounter
Complete traumatic amputation at level between right shoulder and elbow, initial encounter
↔
S48.111S
Sequela
Complete traumatic amputation at level between right shoulder and elbow, sequela

What we found

Same injury, other encounter phase.S48.111A and S48.111S 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.

What to review

Use the 7th character that matches the encounter being coded (initial, subsequent or sequela); one encounter takes one of them.

Guide: 7th characters: initial, subsequent, sequelaCheck these on a claim

Why it matters

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 / rule

ICD-10-CM Official Guidelines, Section I.C.19.a

Side by side

S48.111AComplete traumatic amputation at level between right shoulder and elbow, initial encounterS48.111SComplete traumatic amputation at level between right shoulder and elbow, 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)
DefinitionComplete traumatic amputation at level between right shoulder and elbow, initial encounter is a billable ICD-10-CM diagnosis code (S48.111A).Complete traumatic amputation at level between right shoulder and elbow, sequela is a billable ICD-10-CM diagnosis code (S48.111S).
7th characterThe appropriate 7th character is to be added to each code from category S48The appropriate 7th character is to be added to each code from category S48
Includes
injuries of axilla
injuries of scapular region
injuries of axilla
injuries of scapular region
Excludes1
traumatic amputation at elbow level (S58.0)
traumatic amputation at elbow level (S58.0)
Excludes2
burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of elbow (S50-S59)
insect bite or sting, venomous (T63.4)
burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of elbow (S50-S59)
insect bite or sting, venomous (T63.4)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources