S30-S39 — Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals
ICD-10-CM codes S30-S39 cover injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals, within injury, poisoning and certain other consequences of external causes. The block holds 3,634 codes across 10 categories, of which 2,679 are billable and 955 are header codes that cannot be submitted on a claim. 3,634 of them (100%) require a 7th character.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Includes
Conditions this code covers.
- injuries to the abdominal wall
- injuries to the anus
- injuries to the buttock
- injuries to the external genitalia
- injuries to the flank
- injuries to the groin
The 7th character in S30-S39
A code in this block is not complete without its 7th character, and a missing one is a rejected claim rather than a denied one: the clearinghouse never passes it on. 3,634 of the 3,634 codes here take one.
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment in S30-S39
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 402 Hip Fracture/Dislocation
- HCC 401 Vertebral Fractures without Spinal Cord Injury
- HCC 182 Spinal Cord Disorders/Injuries
What else to watch in S30-S39
- 928 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 2,480 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in S30-S39
- S30Superficial injury of abdomen, lower back, pelvis and external genitals
- S31Open wound of abdomen, lower back, pelvis and external genitals
- S32Fracture of lumbar spine and pelvis
- S33Dislocation and sprain of joints and ligaments of lumbar spine and pelvis
- S34Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level
- S35Injury of blood vessels at abdomen, lower back and pelvis level
- S36Injury of intra-abdominal organs
- S37Injury of urinary and pelvic organs
- S38Crushing injury and traumatic amputation of abdomen, lower back, pelvis and external genitals
- S39Other and unspecified injuries of abdomen, lower back, pelvis and external genitals