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S99.232A vs S99.232K

S99.232A (Salter-Harris Type III physeal fracture of phalanx of left toe, initial encounter for closed fracture) compared with S99.232K (Salter-Harris Type III physeal fracture of phalanx of left toe, subsequent encounter for fracture with nonunion), from the official CMS tabular data. S99.232A and S99.232K code the same injury at a different phase of treatment. MedCoder-derived

Can these codes be reported together?

Review

Encounter relationship

S99.232A
Initial encounter
Salter-Harris Type III physeal fracture of phalanx of left toe, initial encounter for closed fracture
↔
S99.232K
Subsequent encounter
Salter-Harris Type III physeal fracture of phalanx of left toe, subsequent encounter for fracture with nonunion

What we found

Same injury, other encounter phase.S99.232A and S99.232K 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.

What to review

Use the 7th character that matches the encounter being coded (initial, subsequent or sequela); one encounter takes one of them.

Guide: 7th characters: initial, subsequent, sequelaCheck these on a claim

Why it matters

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 / rule

ICD-10-CM Official Guidelines, Section I.C.19.a

Side by side

S99.232ASalter-Harris Type III physeal fracture of phalanx of left toe, initial encounter for closed fractureS99.232KSalter-Harris Type III physeal fracture of phalanx of left toe, subsequent encounter for fracture with nonunion
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)
DefinitionSalter-Harris Type III physeal fracture of phalanx of left toe, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S99.232A).Salter-Harris Type III physeal fracture of phalanx of left toe, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S99.232K).
7th characterThe appropriate 7th character is to be added to each code from subcategories S99.2The appropriate 7th character is to be added to each code from subcategories S99.2
Excludes2
burns and corrosions (T20-T32)
fracture of ankle and malleolus (S82.-)
frostbite (T33-T34)
insect bite or sting, venomous (T63.4)
burns and corrosions (T20-T32)
fracture of ankle and malleolus (S82.-)
frostbite (T33-T34)
insect bite or sting, venomous (T63.4)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources