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S93.511A vs S93.511D

S93.511A (Sprain of interphalangeal joint of right great toe, initial encounter) compared with S93.511D (Sprain of interphalangeal joint of right great toe, subsequent encounter), from the official CMS tabular data. S93.511A and S93.511D code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S93.511A
Initial encounter
Sprain of interphalangeal joint of right great toe, initial encounter
S93.511D
Subsequent encounter
Sprain of interphalangeal joint of right great toe, subsequent encounter

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. S93.511A and S93.511D 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

S93.511ASprain of interphalangeal joint of right great toe, initial encounterS93.511DSprain of interphalangeal joint of right great toe, 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)
DefinitionSprain of interphalangeal joint of right great toe, initial encounter is a billable ICD-10-CM diagnosis code (S93.511A).Sprain of interphalangeal joint of right great toe, subsequent encounter is a billable ICD-10-CM diagnosis code (S93.511D).
7th characterThe appropriate 7th character is to be added to each code from category S93The appropriate 7th character is to be added to each code from category S93
Includes
avulsion of joint or ligament of ankle, foot and toe
laceration of cartilage, joint or ligament of ankle, foot and toe
sprain of cartilage, joint or ligament of ankle, foot and toe
traumatic hemarthrosis of joint or ligament of ankle, foot and toe
avulsion of joint or ligament of ankle, foot and toe
laceration of cartilage, joint or ligament of ankle, foot and toe
sprain of cartilage, joint or ligament of ankle, foot and toe
traumatic hemarthrosis of joint or ligament of ankle, foot and toe

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