S32.019A — Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture
S32.019A is a billable, specific ICD-10-CM code for unspecified fracture of first lumbar vertebra, initial encounter for closed fracture. It is valid for submission on a claim.
7th character "A" — initial encounter for closed fracture
The appropriate 7th character is to be added to each code from category S32
- A
- initial encounter for closed fracture
- B
- initial encounter for open fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- S
- sequela
Risk adjustment
S32.019A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 401 Vertebral Fractures without Spinal Cord Injury0.522 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S32.019A is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56396Billing and Coding: Lumbar Spinal Fusion
- A56722Billing and Coding: Intraoperative Neurophysiological Testing
- A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
- A56802Billing and Coding: Urodynamics
Related codes at this level
Codes that share S32.019. If S32.019A is not quite right, the correct code is usually one of these.
- S32.019BUnspecified fracture of first lumbar vertebra, initial encounter for open fracture
- S32.019DUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with routine healing
- S32.019GUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with delayed healing
- S32.019KUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with nonunion
- S32.019SUnspecified fracture of first lumbar vertebra, sequela
Questions about S32.019A
- Is S32.019A a billable ICD-10-CM code?
- Yes. S32.019A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S32.019A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).