S32.616B: Nondisplaced avulsion fracture of unspecified ischium, initial encounter for open fracture
S32.616B is a billable, specific ICD-10-CM code for nondisplaced avulsion fracture of unspecified ischium, initial encounter for open fracture. It is valid for submission on a claim.
Check S32.616B with the rest of the claim: free scrubber7th character "B": initial encounter for open 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 S32.616B
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S32.616B
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S32.616B
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S32.616B 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
S32.616B 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.
Other codes under S32.616
- S32.616ANondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture
- S32.616DNondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with routine healing
- S32.616GNondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with delayed healing
- S32.616KNondisplaced avulsion fracture of unspecified ischium, subsequent encounter for fracture with nonunion
- S32.616SNondisplaced avulsion fracture of unspecified ischium, sequela