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S89.191A vs S89.191D

S89.191A (Other physeal fracture of lower end of right tibia, initial encounter for closed fracture) compared with S89.191D (Other physeal fracture of lower end of right tibia, subsequent encounter for fracture with routine healing), from the official CMS tabular data. S89.191A and S89.191D code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S89.191A
Initial encounter
Other physeal fracture of lower end of right tibia, initial encounter for closed fracture
S89.191D
Subsequent encounter
Other physeal fracture of lower end of right tibia, subsequent encounter for fracture with routine healing

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. S89.191A and S89.191D 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

S89.191AOther physeal fracture of lower end of right tibia, initial encounter for closed fractureS89.191DOther physeal fracture of lower end of right tibia, subsequent encounter for fracture with routine healing
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)
DefinitionOther physeal fracture of lower end of right tibia, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S89.191A).Other physeal fracture of lower end of right tibia, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S89.191D).
7th characterThe appropriate 7th character is to be added to each code from subcategories S89.0, S89.1, S89.2, and S89.3The appropriate 7th character is to be added to each code from subcategories S89.0, S89.1, S89.2, and S89.3

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