S53.40 vs S56
S53.40 (Unspecified sprain of elbow) compared with S56 (Injury of muscle, fascia and tendon at forearm level), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S53.40 carries an Excludes2 note covering S56: “strain of muscle, fascia and tendon at forearm level (S56.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. S56 carries an Excludes2 note covering S53.40: “sprain of joints and ligaments of elbow (S53.4-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S53.40Unspecified sprain of elbow | S56Injury of muscle, fascia and tendon at forearm level | |
|---|---|---|
| Billing status | Non-billable header Report instead: S53.401A, S53.401D, S53.401S, S53.402A, S53.402D | Non-billable header Report instead: S56.001A, S56.001D, S56.001S, S56.002A, S56.002D |
| 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 | Unspecified sprain of elbow is a non-billable ICD-10-CM category code (S53.40). | Injury of muscle, fascia and tendon at forearm level is a non-billable ICD-10-CM category code (S56). |
| 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 S56 |
| 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 | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources