S27.0XXA — Traumatic pneumothorax, initial encounter
S27.0XXA is a billable, specific ICD-10-CM code for traumatic pneumothorax, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S27
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- spontaneous pneumothorax (J93.-)
Risk adjustment
S27.0XXA does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
S27.0XXA is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A57205Billing and Coding: Oximetry Services
- A57224Billing and Coding: Respiratory Care
Related codes at this level
Codes that share S27.0. If S27.0XXA is not quite right, the correct code is usually one of these.
Questions about S27.0XXA
- Is S27.0XXA a billable ICD-10-CM code?
- Yes. S27.0XXA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S27.0XXA sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the thorax (S20-S29).
- What cannot be coded together with S27.0XXA?
- S27.0XXA carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.