S49.11 vs S49.111A
S49.11 (Salter-Harris Type I physeal fracture of lower end of humerus) compared with S49.111A (Salter-Harris Type I physeal fracture of lower end of humerus, right arm, initial encounter for closed fracture), from the official CMS tabular data.
Summary
These codes represent different levels of the same hierarchy: S49.11 is the non-billable header that contains S49.111A, so only S49.111A (or a sibling) is reported.
Registry fact- What is different?
Title wording and billing status.S49.111A’s title adds “right arm, initial encounter for closed fracture” to the wording the two share (“Salter-Harris Type I physeal fracture of lower end of humerus”). S49.11 is a non-billable header; S49.111A is billable.
Registry fact
- Can these codes be reported together?
Not as a pair.S49.11 is the non-billable header that contains S49.111A. A header is not reported on a claim, so the choice is S49.111A or a sibling that matches the documentation.
Registry fact
- Is there an Excludes1 relationship?
None.Neither entry carries an Excludes1 note that names the other code.
Official rule
- Is there an Excludes2 relationship?
None.Neither entry carries an Excludes2 note that names the other code. S49.11 carries 4 Excludes2 notes and S49.111A carries 4 Excludes2 notes covering other codes; the side-by-side table quotes them.
Official rule
- Is one more specific?
Yes.S49.111A is a subdivision of S49.11 in the tabular hierarchy, so it is the more specific of the two.
Registry fact
- Is one a parent or header code?
Yes.S49.11 is the non-billable header that contains S49.111A. A header stands for the whole family beneath it and is not reported on a claim.
Registry fact
- Are there sequencing instructions?
None.Neither entry carries a Code First or Use Additional Code note that names the other.
Official rule
- Are there other coding relationships?
None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.
MedCoder-derived
Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels
Can these codes be reported together?
Not as a pair — S49.11 is not reportable. S49.11 is the non-billable category that contains S49.111A.
A header stands for the whole family of codes beneath it and is not reported on a claim, so the choice is S49.111A or a sibling that matches the documentation. No Excludes1/Excludes2 relationship exists between these codes in the official tabular list.
Official guidance behind these answers
Section I.B.2 — Level of Detail in Coding · applies to: S49.11 and S49.111A
Diagnosis codes are to be used and reported at their highest number of characters available and to the highest level of specificity documented in the medical record. ICD-10-CM diagnosis codes are composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth and/or fifth characters and/or sixth characters, which provide greater detail. A three-character code is to be used only if it is not further subdivided. A code is invalid if it has not been coded to the full number of characters required for that code, including the 7th character, if applicable.
ICD-10-CM Official Guidelines FY2026
Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum
Side by side
| S49.11Salter-Harris Type I physeal fracture of lower end of humerus | S49.111ASalter-Harris Type I physeal fracture of lower end of humerus, right arm, initial encounter for closed fracture | |
|---|---|---|
| Billing status | Non-billable header Report instead: S49.111A, S49.111D, S49.111G, S49.111K, S49.111P | 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 | Salter-Harris Type I physeal fracture of lower end of humerus is a non-billable ICD-10-CM category code (S49.11). | Salter-Harris Type I physeal fracture of lower end of humerus, right arm, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S49.111A). |
| 7th character | The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1 | The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1 |
| Includes | injuries of axilla injuries of scapular region | injuries of axilla injuries of scapular region |
| 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.
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