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S52.91XG ICD-10-CM Code: Unspecified fracture of right forearm, subsequent encounter for closed fracture with delayed healing

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
1 Excludes1 · 6 Excludes2

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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
  • MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S52.91XG in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on S52.91XG itself; “inherited from” names the category or block whose note applies here.

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 S52

Excludes2 — Not Included Here

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

7th Character Guide

"The appropriate 7th character is to be added to all codes from category S52"

  • A — initial encounter for closed fracture
  • B — initial encounter for open fracture type I or II
  • C — initial encounter for open fracture type IIIA, IIIB, or IIIC
  • D — subsequent encounter for closed fracture with routine healing
  • E — subsequent encounter for open fracture type I or II with routine healing
  • F — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
  • G — subsequent encounter for closed fracture with delayed healing (this page’s code)
  • H — subsequent encounter for open fracture type I or II with delayed healing
  • J — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
  • K — subsequent encounter for closed fracture with nonunion
  • M — subsequent encounter for open fracture type I or II with nonunion
  • N — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
  • P — subsequent encounter for closed fracture with malunion
  • Q — subsequent encounter for open fracture type I or II with malunion
  • R — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
  • 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

S52.91XA, S52.91XB, S52.91XC, S52.91XD, S52.91XE, S52.91XF, S52.91XG, S52.91XH, S52.91XJ, S52.91XK, S52.91XM, S52.91XN, S52.91XP, S52.91XQ, S52.91XR, S52.91XS

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.

Coder workflow for S52.91XG

MedCoder structured workflow — derived from this code’s own official record

Before you code S52.91XG

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, S52.91XG may be the appropriate code. Check the record for detail that supports a more specific sibling — in this subcategory the siblings differ by the presence or absence of the associated condition, open versus closed. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    See the hierarchy · Guide: Other vs unspecified (NEC vs NOS) →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. This page’s code carries “G”. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

  4. S52.91XG’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  5. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. A fracture not documented as open or closed is coded as closed; one not documented as displaced or nondisplaced is coded as displaced. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1, I.C.19.c).

    Guide: Traumatic vs pathological vs stress fracture →

  6. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with S52.91XG. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — S52.91XG is appropriate when the documentation goes no further.
  2. Does the documentation support a condition named in S52.91XG’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewS58

  3. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.
  4. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider S52.91XG. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Open or closed; displaced or nondisplaced
Defaults apply when the record is silent: closed, and displaced (Guidelines I.C.19.c).
External cause, place and activity
For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting S52.91XG(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with S52.91XG: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareS58

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of S52.91XG(6 notes)

    Coding workflow: The conditions named in this note are not included in S52.91XG. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareS62, M97.4, T63.4

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the subcategory for a sibling that names the missing detail.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

Documentation: Both the condition S52.91XG describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewS58

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Unspecified fracture of right forearm, subsequent encounter for closed fracture with delayed healing is a billable ICD-10-CM diagnosis code (S52.91XG).

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. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 6 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

  • 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 in Claim Check.

Relationships & Classification

Other codes that name S52.91XG 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 across 2 chapters: M84.3 — Stress fracture (via S52.-), M84.4 — Pathological fracture, not elsewhere classified (via S52.-), S51 — Open wound of elbow and forearm (via S52.-).

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

Referenced by 12 Excludes2 notes: S40 — Superficial injury of shoulder and upper arm (via S52.-), S40-S49 — Injuries to the shoulder and upper arm (S40-S49) (via S52.-), S41 — Open wound of shoulder and upper arm (via S52.-), S42 — Fracture of shoulder and upper arm (via S52.-), S43 — Dislocation and sprain of joints and ligaments of shoulder girdle (via S52.-), S44 — Injury of nerves at shoulder and upper arm level (via S52.-), S45 — Injury of blood vessels at shoulder and upper arm level (via S52.-), S46 — Injury of muscle, fascia and tendon at shoulder and upper arm level (via S52.-), S47 — Crushing injury of shoulder and upper arm (via S52.-), S48 — Traumatic amputation of shoulder and upper arm (via S52.-), S49 — Other and unspecified injuries of shoulder and upper arm (via S52.-), S62 — Fracture at wrist and hand level (via S52.-).

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

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 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).

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

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.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

S52.90XG — Unspecified fracture of unspecified forearm, subsequent encounter for closed fracture with delayed healing (unspecified)Compare S52.91XG vs S52.90XG →, S52.92XG — Unspecified fracture of left forearm, subsequent encounter for closed fracture with delayed healing (left)Compare S52.91XG vs S52.92XG →

Same injury, other encounter phase

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

S52.91XA — Unspecified fracture of right forearm, initial encounter for closed fractureCompare S52.91XG vs S52.91XA →, S52.91XB — Unspecified fracture of right forearm, initial encounter for open fracture type I or II, S52.91XC — Unspecified fracture of right forearm, initial encounter for open fracture type IIIA, IIIB, or IIIC, S52.91XD — Unspecified fracture of right forearm, subsequent encounter for closed fracture with routine healing, S52.91XE — Unspecified fracture of right forearm, subsequent encounter for open fracture type I or II with routine healing, S52.91XF — Unspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing, S52.91XH — Unspecified fracture of right forearm, subsequent encounter for open fracture type I or II with delayed healing, S52.91XJ — Unspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing, S52.91XK — Unspecified fracture of right forearm, subsequent encounter for closed fracture with nonunion, S52.91XM — Unspecified fracture of right forearm, subsequent encounter for open fracture type I or II with nonunion, S52.91XN — Unspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion, S52.91XP — Unspecified fracture of right forearm, subsequent encounter for closed fracture with malunion, S52.91XQ — Unspecified fracture of right forearm, subsequent encounter for open fracture type I or II with malunion, S52.91XR — Unspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion, S52.91XS — Unspecified fracture of right forearm, sequela

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Fracture of the upper limb, subsequent encounter).

+4347 more

Contextual Map

Every relationship of S52.91XG 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 S52.91XG with these 11 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • M84.3 — Stress fracture[Excludes1](via S52.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • M84.4 — Pathological fracture, not elsewhere classified[Excludes1](via S52.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • S51 — Open wound of elbow and forearm[Excludes1](via S52.-): “open fracture of elbow and forearm (S52.- with open fracture 7th character)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (12)

Clinical classification (CCSR)

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

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 S52.91XG require a 7th character?

Yes. The appropriate 7th character is to be added to all codes from category S52.

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
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
    Unspecified fracture of right forearm, subsequent encounter for closed fracture with delayed healing

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 S52.91XG in its code family, with their registry titles.

View all codes in the S52 family