S26.12XA
S26.12XA: Laceration of heart without hemopericardium, initial encounter
Billable / specific codeICD-10-CM
S26.12XA is a billable, specific ICD-10-CM code for laceration of heart without hemopericardium, initial encounter. It is valid for submission on a claim.
Check S26.12XA with the rest of the claim: free scrubber7th character "A": initial encounter
The appropriate 7th character is to be added to each code from category S26
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Other codes that can never be billed with S26.12XA
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S26.12XA is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56625Billing and Coding: Echocardiography
- A56781Billing and Coding: Transthoracic Echocardiography (TTE)
Code history
Unchanged in every release from FY2024 to FY2027.