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ICD-10/S49.131K

S49.131K ICD-10-CM Code: Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with nonunion

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 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)
  • MS-DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)
  • MS-DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC (MDC 08)

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.

Official Registry Overview & Definition

Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S49.131K).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S49.131K in the official ICD-10-CM tabular list.

Includes

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

  • injuries of axilla
  • injuries of scapular region

Excludes2 — Not Included Here

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

Change history

  • FY2017 — 2016-10-01
    Description revised
    Salter Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with nonunion → Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with nonunion
    FY2017 changes
  • FY2017 — 2016-10-01
    Short description revised
    Sltr-haris Type III physl fx low end humer, r arm, 7thK → Sltr-haris Type III physl fx low end humer, right arm, 7thK
    FY2017 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

Contextual Map

Every relationship of S49.131K 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]
  • S40-S49 — Injuries to the shoulder and upper arm [Hierarchy]

Referenced by Excludes2 notes

  • S42.3 — Fracture of shaft of humerus [Excludes2](via S49.1.-): “physeal fractures of lower end of humerus (S49.1-)” · check together
  • S42.4 — Fracture of lower end of humerus [Excludes2](via S49.1.-): “physeal fracture of lower end of humerus (S49.1-)” · check together

Clinical classification (CCSR)

  • INJ041 — Fracture of the upper limb, subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)”
  • DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)”
  • DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC (MDC 08)”

MDC crossing · procedures (18508)

  • 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.”
  • 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 18503 more

Nearest codes (40)

  • S49 — Other and unspecified injuries of shoulder and upper arm [Sibling]
  • S49.121S — Salter-Harris Type II physeal fracture of lower end of humerus, right arm, sequela [Sibling]
  • S49.122 — Salter-Harris Type II physeal fracture of lower end of humerus, left arm [Sibling]
  • S49.122A — Salter-Harris Type II physeal fracture of lower end of humerus, left arm, initial encounter for closed fracture [Sibling]
  • S49.122D — Salter-Harris Type II physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with routine healing [Sibling]
  • S49.122G — Salter-Harris Type II physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with delayed healing [Sibling]
  • S49.122K — Salter-Harris Type II physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with nonunion [Sibling]
  • S49.122P — Salter-Harris Type II physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with malunion [Sibling]
  • and 32 more

Change history (2)

  • FY2017 — Description revised [Change history]
  • and 1 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):INJ041 — Fracture of the upper limb, subsequent encounter (default).

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

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 3 MS-DRGs: DRG 564 (MDC 08), DRG 565 (MDC 08), DRG 566 (MDC 08).

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

Official ICD-10-CM tabular notes on other codes that name S49.131K or its code family.

2 Excludes2 notes: S42.3 (via S49.1.-), S42.4 (via S49.1.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S49.131K require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S49.131K in its code family, with their registry titles.

  • S49.13 — Salter-Harris Type III physeal fracture of lower end of humerus
  • S49.131 — Salter-Harris Type III physeal fracture of lower end of humerus, right arm
  • S49.131A — Salter-Harris Type III physeal fracture of lower end of humerus, right arm, initial encounter for closed fracture
  • S49.131D — Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with routine healing
  • S49.131G — Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with delayed healing
  • S49.131P — Salter-Harris Type III physeal fracture of lower end of humerus, right arm, subsequent encounter for fracture with malunion
  • S49.131S — Salter-Harris Type III physeal fracture of lower end of humerus, right arm, sequela
  • S49.132 — Salter-Harris Type III physeal fracture of lower end of humerus, left arm
  • S49.132A — Salter-Harris Type III physeal fracture of lower end of humerus, left arm, initial encounter for closed fracture
  • S49.132D — Salter-Harris Type III physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with routine healing

View all codes in the S49 family