S60.446A (External constriction of right little finger, initial encounter) compared with S60.446D (External constriction of right little finger, subsequent encounter), from the official CMS tabular data. S60.446A and S60.446D 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. S60.446A and S60.446D 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.
| S60.446AExternal constriction of right little finger, initial encounter | S60.446DExternal constriction of right little finger, subsequent encounter | |
|---|---|---|
| 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 | External constriction of right little finger, initial encounter is a billable ICD-10-CM diagnosis code (S60.446A). | External constriction of right little finger, subsequent encounter is a billable ICD-10-CM diagnosis code (S60.446D). |
| 7th character | The appropriate 7th character is to be added to each code from category S60 | The appropriate 7th character is to be added to each code from category S60 |
| Use additional code | cause code to identify the constricting item (W49.0-) | cause code to identify the constricting item (W49.0-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources