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S32.14XB ICD-10-CM Code: Type 1 fracture of sacrum, initial encounter for open fracture

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
12 inclusion terms · 1 Excludes1 · 7 Excludes2 · 1 code-first instruction · 1 code-also instruction
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 169

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 551 — MEDICAL BACK PROBLEMS WITH MCC (MDC 08)
  • MS-DRG 552 — MEDICAL BACK PROBLEMS WITHOUT MCC (MDC 08)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 401 — Vertebral Fractures without Spinal Cord Injury

Other models: CMS-HCC V22 HCC 169

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S32.14XB in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on S32.14XB itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • fracture of lumbosacral neural arch inherited from S32
  • fracture of lumbosacral spinous process inherited from S32
  • fracture of lumbosacral transverse process inherited from S32
  • fracture of lumbosacral vertebra inherited from S32
  • fracture of lumbosacral vertebral arch inherited from S32
  • injuries to the abdominal wall inherited from S30-S39
  • injuries to the anus inherited from S30-S39
  • injuries to the buttock inherited from S30-S39
  • injuries to the external genitalia inherited from S30-S39
  • injuries to the flank inherited from S30-S39
  • injuries to the groin inherited from S30-S39

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Transverse flexion fracture of sacrum without displacement

Source: inherited from S32.14

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from S32

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • any associated spinal cord and spinal nerve injury (S34.-)

Source: inherited from S32

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated fracture of pelvic ring (S32.8-)

Source: inherited from S32.1

7th Character Guide

"The appropriate 7th character is to be added to each code from category S32"

  • A — initial encounter for closed fracture
  • B — initial encounter for open fracture (this page’s code)
  • D — subsequent encounter for fracture with routine healing
  • G — subsequent encounter for fracture with delayed healing
  • K — subsequent encounter for fracture with nonunion
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S32.14XA, S32.14XB, S32.14XD, S32.14XG, S32.14XK, S32.14XS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Code Overview

Type 1 fracture of sacrum, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S32.14XB).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)

c. Coding of Traumatic Fractures The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site in accordance with both the provisions within categories S02, S12, S22, S32, S42, S49, S52, S59, S62, S72, S79, S82, S89, S92 and the level of detail furnished by medical record content.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. Sequencing: 1 Code First instruction — the underlying condition is sequenced before this code when present. See the Code First notes
  3. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  4. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  5. 7 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

Other codes that name S32.14XB or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes1 notes: M48.5 — Collapsed vertebra, not elsewhere classified (via S32.-), M84.3 — Stress fracture (via S32.-), M84.4 — Pathological fracture, not elsewhere classified (via S32.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: S31 — Open wound of abdomen, lower back, pelvis and external genitals (via S32.1.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Use Additional Code instruction: S38.1 — Crushing injury of abdomen, lower back, and pelvis (via S32.-).

These codes instruct coders to additionally report this code when it applies.

Referenced by 1 Code Also instruction: S32.8 — Fracture of other parts of pelvis (via S32.1.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 415 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).

Potential MS-DRG participation — not a DRG assignment.

Named in the grouper logic of 5 MS-DRGs: DRG 551 (MDC 08), DRG 552 (MDC 08), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ002 — Fracture of the spine and back, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same injury, other encounter phase

Same injury, coded at a different phase of treatment via the 7th character.

S32.14XA — Type 1 fracture of sacrum, initial encounter for closed fractureCompare S32.14XB vs S32.14XA →, S32.14XD — Type 1 fracture of sacrum, subsequent encounter for fracture with routine healing, S32.14XG — Type 1 fracture of sacrum, subsequent encounter for fracture with delayed healing, S32.14XK — Type 1 fracture of sacrum, subsequent encounter for fracture with nonunion, S32.14XS — Type 1 fracture of sacrum, sequela

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Vertebral Fractures without Spinal Cord Injury) for risk-adjusted payment.

S32.129B — Unspecified Zone II fracture of sacrum, initial encounter for open fracture, S32.130A — Nondisplaced Zone III fracture of sacrum, initial encounter for closed fracture, S32.130B — Nondisplaced Zone III fracture of sacrum, initial encounter for open fracture, S32.131A — Minimally displaced Zone III fracture of sacrum, initial encounter for closed fracture, S32.131B — Minimally displaced Zone III fracture of sacrum, initial encounter for open fracture, S32.132A — Severely displaced Zone III fracture of sacrum, initial encounter for closed fracture, S32.132B — Severely displaced Zone III fracture of sacrum, initial encounter for open fracture, S32.139A — Unspecified Zone III fracture of sacrum, initial encounter for closed fracture, S32.139B — Unspecified Zone III fracture of sacrum, initial encounter for open fracture, S32.14XA — Type 1 fracture of sacrum, initial encounter for closed fracture, S32.15XA — Type 2 fracture of sacrum, initial encounter for closed fracture, S32.15XB — Type 2 fracture of sacrum, initial encounter for open fracture, S32.16XA — Type 3 fracture of sacrum, initial encounter for closed fracture, S32.16XB — Type 3 fracture of sacrum, initial encounter for open fracture, S32.17XA — Type 4 fracture of sacrum, initial encounter for closed fracture, S32.17XB — Type 4 fracture of sacrum, initial encounter for open fracture, S32.19XA — Other fracture of sacrum, initial encounter for closed fracture, S32.19XB — Other fracture of sacrum, initial encounter for open fracture, S32.2XXA — Fracture of coccyx, initial encounter for closed fracture, S32.2XXB — Fracture of coccyx, initial encounter for open fracture, +318 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Fracture of the spine and back, initial encounter).

+329 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of S32.14XB in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run S32.14XB with these 6 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 401 — Vertebral Fractures without Spinal Cord Injury [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 18,508 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
  • MDC 24 — Multiple Significant Trauma[MDC crossing]: “Multiple Significant Trauma — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 22,957 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Does S32.14XB require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S32.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Type 1 fracture of sacrum, initial encounter for open fracture

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S32.14XB in its code family, with their registry titles.

View all codes in the S32 family