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S63.490A vs S63.490D

S63.490A (Traumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, initial encounter) compared with S63.490D (Traumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, subsequent encounter), from the official CMS tabular data. S63.490A and S63.490D code the same injury at a different phase of treatment.

Can these codes be reported together?

Same injury, other encounter phase. S63.490A and S63.490D 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.

Side by side

S63.490ATraumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, initial encounterS63.490DTraumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, subsequent encounter
Billing statusBillableBillable
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)
DefinitionTraumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, initial encounter is a billable ICD-10-CM diagnosis code (S63.490A).Traumatic rupture of other ligament of right index finger at metacarpophalangeal and interphalangeal joint, subsequent encounter is a billable ICD-10-CM diagnosis code (S63.490D).
7th characterThe appropriate 7th character is to be added to each code from category S63The appropriate 7th character is to be added to each code from category S63
Includes
avulsion of joint or ligament at wrist and hand level
laceration of cartilage, joint or ligament at wrist and hand level
sprain of cartilage, joint or ligament at wrist and hand level
traumatic hemarthrosis of joint or ligament at wrist and hand level
avulsion of joint or ligament at wrist and hand level
laceration of cartilage, joint or ligament at wrist and hand level
sprain of cartilage, joint or ligament at wrist and hand level
traumatic hemarthrosis of joint or ligament at wrist and hand level

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources