S52.091A (Other fracture of upper end of right ulna, initial encounter for closed fracture)
compared with
S52.091R (Other fracture of upper end of right ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion),
from the official CMS tabular data. S52.091A and S52.091R code the same injury at a different phase of treatment.
Other fracture of upper end of right ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
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. S52.091A and S52.091R 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.
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
Other fracture of upper end of right ulna, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S52.091A).
Other fracture of upper end of right ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S52.091R).
7th character
The appropriate 7th character is to be added to all codes from category S52
The appropriate 7th character is to be added to all codes from category S52