S64.490A (Injury of digital nerve of right index finger, initial encounter) compared with S64.490S (Injury of digital nerve of right index finger, sequela), from the official CMS tabular data. S64.490A and S64.490S code the same injury at a different phase of treatment. MedCoder-derived
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. S64.490A and S64.490S 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.
| S64.490AInjury of digital nerve of right index finger, initial encounter | S64.490SInjury of digital nerve of right index finger, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, poisoning and certain other consequences of external causes | S00-T88 — Injury, poisoning and certain other consequences of external causes |
| Definition | Injury of digital nerve of right index finger, initial encounter is a billable ICD-10-CM diagnosis code (S64.490A). | Injury of digital nerve of right index finger, sequela is a billable ICD-10-CM diagnosis code (S64.490S). |
| 7th character | The appropriate 7th character is to be added to each code from category S64 | The appropriate 7th character is to be added to each code from category S64 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources