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S58.019D vs S68

S58.019D (Complete traumatic amputation at elbow level, unspecified arm, subsequent encounter) compared with S68 (Traumatic amputation of wrist, hand and fingers), from the official CMS tabular data.

Summary

These codes should not be reported together because S58.019D’s tabular entry lists S68 under Excludes1.

Official rule
What is different?

The conditions named and billing status.S58.019D is “Complete traumatic amputation at elbow level, unspecified arm, subsequent encounter”; S68 is “Traumatic amputation of wrist, hand and fingers”. S68 is a non-billable header; S58.019D is billable.

Registry fact

Can these codes be reported together?

No.S58.019D’s entry carries an Excludes1 note covering S68: “traumatic amputation of wrist and hand (S68.-)”. 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.S58.019D’s tabular entry: “traumatic amputation of wrist and hand (S68.-)”. The note covers S68.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.S58.019D’s tabular entry: “injuries of wrist and hand (S60-S69)”. The note covers S68.

Official ruleGuide: Excludes1 vs Excludes2

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?

One is a header.S68 is a non-billable header, but S58.019D is not one of its subdivisions.

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

S58.019D
Complete traumatic amputation at elbow level, unspecified arm, subsequent encounter
↔
S68
Traumatic amputation of wrist, hand and fingers

What we found

No — do not report together.S58.019D carries an Excludes1 note covering S68: “traumatic amputation of wrist and hand (S68.-)”

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

Informational

Excludes2 relationship

S58.019D
Complete traumatic amputation at elbow level, unspecified arm, subsequent encounter
↔
S68
Traumatic amputation of wrist, hand and fingers

What we found

Yes, when both are documented.S58.019D carries an Excludes2 note covering S68: “injuries of wrist and hand (S60-S69)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

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 FY2026

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

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

S58.019DComplete traumatic amputation at elbow level, unspecified arm, subsequent encounterS68Traumatic amputation of wrist, hand and fingers
Billing statusBillableNon-billable header

Report instead: S68.011A, S68.011D, S68.011S, S68.012A, S68.012D

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)
DefinitionComplete traumatic amputation at elbow level, unspecified arm, subsequent encounter is a billable ICD-10-CM diagnosis code (S58.019D).Traumatic amputation of wrist, hand and fingers is a non-billable ICD-10-CM category code (S68).
7th characterThe appropriate 7th character is to be added to each code from category S58The appropriate 7th character is to be added to each code from category S68
Includes—
An amputation not identified as partial or complete should be coded to complete
Excludes1
traumatic amputation of wrist and hand (S68.-)
—
Excludes2
burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of wrist and hand (S60-S69)
insect bite or sting, venomous (T63.4)
burns and corrosions (T20-T32)
frostbite (T33-T34)
insect bite or sting, venomous (T63.4)

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.

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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