S59.091A (Other physeal fracture of lower end of ulna, right arm, initial encounter for closed fracture) compared with S59.091S (Other physeal fracture of lower end of ulna, right arm, sequela), from the official CMS tabular data. S59.091A and S59.091S code the same injury at a different phase of treatment.
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. S59.091A and S59.091S 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.
| S59.091AOther physeal fracture of lower end of ulna, right arm, initial encounter for closed fracture | S59.091SOther physeal fracture of lower end of ulna, right arm, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| 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 | Other physeal fracture of lower end of ulna, right arm, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S59.091A). | Other physeal fracture of lower end of ulna, right arm, sequela is a billable ICD-10-CM diagnosis code (S59.091S). |
| 7th character | The appropriate 7th character is to be added to each code from subcategories S59.0, S59.1, and S59.2 | The appropriate 7th character is to be added to each code from subcategories S59.0, S59.1, and S59.2 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources