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S52.27 vs S53.004

S52.27 (Monteggia's fracture of ulna) compared with S53.004 (Unspecified dislocation of right radial head), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes should not be reported together because S53.004’s tabular entry lists S52.27 under Excludes1.

Official rule
What is different?

The conditions named.S52.27 is “Monteggia's fracture of ulna”; S53.004 is “Unspecified dislocation of right radial head”.

Registry fact

Can these codes be reported together?

No.S53.004’s entry carries an Excludes1 note covering S52.27: “Monteggia's fracture-dislocation (S52.27-)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.S53.004’s tabular entry: “Monteggia's fracture-dislocation (S52.27-)”. The note covers S52.27.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. S52.27 carries 6 Excludes2 notes and S53.004 carries 5 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

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?

Excludes1 — generally not reported together

Excludes1 conflict

S53.004
Unspecified dislocation of right radial head
↔
S52.27
Monteggia's fracture of ulna

What we found

No — do not report together.S53.004 carries an Excludes1 note covering S52.27: “Monteggia's fracture-dislocation (S52.27-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2027

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

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
S52.27

Monteggia's fracture of ulna

S53.004

Unspecified dislocation of right radial head

StatusDiffers
S52.27
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S52.271A, S52.271B, S52.271C, S52.271D, S52.271E

S53.004
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S53.004A, S53.004D, S53.004S

Excludes1Differs
S52.27
  • traumatic amputation of forearm (S58.-)
S53.004
  • Monteggia's fracture-dislocation (S52.27-)
Excludes2Differs
S52.27
  • fracture at wrist and hand level (S62.-)
  • periprosthetic fracture around internal prosthetic elbow joint (M97.4)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of wrist and hand (S60-S69)
  • insect bite or sting, venomous (T63.4)
S53.004
  • strain of muscle, fascia and tendon at forearm level (S56.-)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of wrist and hand (S60-S69)
  • insect bite or sting, venomous (T63.4)
Code alsoDiffers
S52.27

None at this code

S53.004
  • any associated open wound
CategoryDiffers
S52.27

S52 Fracture of forearm

S53.004

S53 Dislocation and sprain of joints and ligaments of elbow

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

IncludesDiffers
S52.27
  • Fracture of upper shaft of ulna with dislocation of radial head
S53.004
  • avulsion of joint or ligament of elbow
  • laceration of cartilage, joint or ligament of elbow
  • sprain of cartilage, joint or ligament of elbow
  • traumatic hemarthrosis of joint or ligament of elbow
7th characterDiffers
S52.27
  • The appropriate 7th character is to be added to all codes from category S52
S53.004
  • The appropriate 7th character is to be added to each code from category S53

No Code first and Use additional code note at either code.

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. In a row that differs, notes every code shares are dimmed.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources