S32.599A

S32.599A: Other specified fracture of unspecified pubis, initial encounter for closed fracture

Billable / specific codeICD-10-CM

S32.599A is a billable, specific ICD-10-CM code for other specified fracture of unspecified pubis, initial encounter for closed fracture. It is valid for submission on a claim.

Check S32.599A with the rest of the claim: free scrubber

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

Excludes1 inherited from the categories above S32.599A

A category’s note binds every code beneath it.

Written on S32.5: Fracture of pubis

fracture of pubis with associated disruption of pelvic ring (S32.8-)

Written on S32: Fracture of lumbar spine and pelvis

transection of abdomen (S38.3)

Excludes2 inherited from the categories above S32.599A

Not part of this code, but both may be coded when both are present.

Written on S32: Fracture of lumbar spine and pelvis

fracture of hip NOS (S72.0-)

Other codes that can never be billed with S32.599A

Their own Excludes1 notes name this code, so the conflict is not listed above.

M48.5Collapsed vertebra, not elsewhere classified
M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified

Risk adjustment

S32.599A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 402 Hip Fracture/Dislocation0.467 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

S32.599A is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A57765Billing and Coding: Major Joint Replacement (Hip and Knee)

Code history

Unchanged in every release from FY2024 to FY2027.