S32.616S
S32.616S — Nondisplaced avulsion fracture of unspecified ischium, sequela
Billable / specific codeICD-10-CMPOA exempt
S32.616S is a billable, specific ICD-10-CM code for nondisplaced avulsion fracture of unspecified ischium, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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
S32.616S 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
S32.616S is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53065Billing and Coding: Outpatient Physical Therapy
- A57765Billing and Coding: Major Joint Replacement (Hip and Knee)
Related codes at this level
Codes that share S32.616. If S32.616S is not quite right, the correct code is usually one of these.
- S32.616ANondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture
- S32.616BNondisplaced avulsion fracture of unspecified ischium, initial encounter for open 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
Questions about S32.616S
- Is S32.616S a billable ICD-10-CM code?
- Yes. S32.616S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S32.616S 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).