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S32.17XB ICD-10-CM Code: Type 4 fracture of sacrum, initial encounter for open fracture

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

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, 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.

Code Overview

Type 4 fracture of sacrum, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S32.17B).

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

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S32.17XB in the official ICD-10-CM tabular list.

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 segmental comminution of upper sacrum inherited from S32.17

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).

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.-) inherited from S32

Code Also

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

  • any associated fracture of pelvic ring (S32.8-) inherited from S32.1

Frequently Compared Codes

The official Excludes notes on S32.17XB name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2016 — 2015-10-01
    In the code set at ICD-10-CM adoption
    Type 4 fracture of sacrum, initial encounter for open fracture

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

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 S32.17XB 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 (via S32.-), M84.3 (via S32.-), M84.4 (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 (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 (via S32.-).

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

Referenced by 1 Code Also instruction: S32.8 (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).

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.

S32.17XA — Type 4 fracture of sacrum, initial encounter for closed fracture Compare S32.17XB vs S32.17XA →, S32.17XD — Type 4 fracture of sacrum, subsequent encounter for fracture with routine healing, S32.17XG — Type 4 fracture of sacrum, subsequent encounter for fracture with delayed healing, S32.17XK — Type 4 fracture of sacrum, subsequent encounter for fracture with nonunion, S32.17XS — Type 4 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, S32.14XB — Type 1 fracture of sacrum, initial encounter for open 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, S32.19XA — 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 S32.17XB 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.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S30-S39 — Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals [Hierarchy]

Referenced by Excludes1 notes

  • M48.5 — Collapsed vertebra, not elsewhere classified [Excludes1](via S32.-): “traumatic fracture of vertebra (S12.-, S22.-, S32.-)” · check together
  • M84.3 — Stress fracture [Excludes1](via S32.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via S32.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together

Referenced by Excludes2 notes

  • S31 — Open wound of abdomen, lower back, pelvis and external genitals [Excludes2](via S32.1.-): “open fracture of pelvis (S32.1--S32.9 with 7th character B)” · check together

Referenced by Use Additional Code instructions

  • S38.1 — Crushing injury of abdomen, lower back, and pelvis [Use Additional Code](via S32.-): “fracture of thoracic or lumbar spine and pelvis (S22.0-, S32.-)” · check together

Referenced by Code Also instructions

  • S32.8 — Fracture of other parts of pelvis [Code Also](via S32.1.-): “sacral fracture (S32.1-)” · check together

Clinical classification (CCSR)

  • INJ002 — Fracture of the spine and back, initial encounter [CCSR]

Risk adjustment (CMS-HCC)

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

MS-DRG Grouper

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC). Not counted when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).”
  • DRG 551 — MEDICAL BACK PROBLEMS WITH MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITH MCC (MDC 08)”
  • DRG 552 — MEDICAL BACK PROBLEMS WITHOUT MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITHOUT MCC (MDC 08)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
  • DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”

MDC crossing · procedures (41465)

  • 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.”
  • 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.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 41460 more

Nearest codes (40)

  • S32 — Fracture of lumbar spine and pelvis [Sibling]
  • S32.14XD — Type 1 fracture of sacrum, subsequent encounter for fracture with routine healing [Sibling]
  • S32.14XG — Type 1 fracture of sacrum, subsequent encounter for fracture with delayed healing [Sibling]
  • S32.14XK — Type 1 fracture of sacrum, subsequent encounter for fracture with nonunion [Sibling]
  • S32.14XS — Type 1 fracture of sacrum, sequela [Sibling]
  • S32.15 — Type 2 fracture of sacrum [Sibling]
  • S32.15XA — Type 2 fracture of sacrum, initial encounter for closed fracture [Sibling]
  • S32.15XB — Type 2 fracture of sacrum, initial encounter for open fracture [Sibling]
  • and 32 more

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S32.17XB require a 7th character?

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S32.17XB in its code family, with their registry titles.

  • S32.16XG — Type 3 fracture of sacrum, subsequent encounter for fracture with delayed healing
  • S32.16XK — Type 3 fracture of sacrum, subsequent encounter for fracture with nonunion
  • S32.16XS — Type 3 fracture of sacrum, sequela
  • S32.17 — Type 4 fracture of sacrum
  • S32.17XA — Type 4 fracture of sacrum, initial encounter for closed fracture
  • S32.17XD — Type 4 fracture of sacrum, subsequent encounter for fracture with routine healing
  • S32.17XG — Type 4 fracture of sacrum, subsequent encounter for fracture with delayed healing
  • S32.17XK — Type 4 fracture of sacrum, subsequent encounter for fracture with nonunion
  • S32.17XS — Type 4 fracture of sacrum, sequela
  • S32.19 — Other fracture of sacrum

View all codes in the S32 family