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S53.491 vs S53.499

S53.491 (Other sprain of right elbow) compared with S53.499 (Other sprain of unspecified elbow), from the official CMS tabular data. S53.491 and S53.499 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S53.491
Right
Other sprain of right elbow
S53.499
Unspecified
Other sprain of unspecified elbow

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. S53.491 and S53.499 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

S53.491Other sprain of right elbowS53.499Other sprain of unspecified elbow
Billing statusNon-billable header

Report instead: S53.491A, S53.491D, S53.491S

Non-billable header

Report instead: S53.499A, S53.499D, S53.499S

ClassificationS00-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)
DefinitionOther sprain of right elbow is a non-billable ICD-10-CM category code (S53.491).Other sprain of unspecified elbow is a non-billable ICD-10-CM category code (S53.499).
7th characterThe appropriate 7th character is to be added to each code from category S53The 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