S59.199A (Other physeal fracture of upper end of radius, unspecified arm, initial encounter for closed fracture)
compared with
S59.199K (Other physeal fracture of upper end of radius, unspecified arm, subsequent encounter for fracture with nonunion),
from the official CMS tabular data. S59.199A and S59.199K code the same injury at a different phase of treatment.
Other physeal fracture of upper end of radius, unspecified arm, subsequent encounter for fracture with nonunion
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
Can these codes be reported together?
Same injury, other encounter phase. S59.199A and S59.199K 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.
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 upper end of radius, unspecified arm, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S59.199A).
Other physeal fracture of upper end of radius, unspecified arm, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S59.199K).
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