S53.20 vs S53.43
S53.20 (Traumatic rupture of unspecified radial collateral ligament) compared with S53.43 (Radial collateral ligament sprain), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. S53.20 carries an Excludes1 note covering S53.43: “sprain of radial collateral ligament NOS (S53.43-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. S53.43 carries an Excludes2 note covering S53.20: “traumatic rupture of radial collateral ligament (S53.2-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S53.20Traumatic rupture of unspecified radial collateral ligament | S53.43Radial collateral ligament sprain | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header Report instead: S53.431A, S53.431D, S53.431S, S53.432A, S53.432D |
| 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 | Traumatic rupture of unspecified radial collateral ligament is a non-billable ICD-10-CM category code (S53.20). | Radial collateral ligament sprain is a non-billable ICD-10-CM category code (S53.43). |
| 7th character | The appropriate 7th character is to be added to each code from category S53 | The appropriate 7th character is to be added to each code from category S53 |
| Includes | 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 | 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 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources