S53.412A (Radiohumeral (joint) sprain of left elbow, initial encounter) compared with S53.412S (Radiohumeral (joint) sprain of left elbow, sequela), from the official CMS tabular data. S53.412A and S53.412S code the same injury at a different phase of treatment. MedCoder-derived
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
Same injury, other encounter phase. S53.412A and S53.412S 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.
| S53.412ARadiohumeral (joint) sprain of left elbow, initial encounter | S53.412SRadiohumeral (joint) sprain of left elbow, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, poisoning and certain other consequences of external causes | S00-T88 — Injury, poisoning and certain other consequences of external causes |
| Definition | Radiohumeral (joint) sprain of left elbow, initial encounter is a billable ICD-10-CM diagnosis code (S53.412A). | Radiohumeral (joint) sprain of left elbow, sequela is a billable ICD-10-CM diagnosis code (S53.412S). |
| 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