S32.699D

S32.699D: Other specified fracture of unspecified ischium, subsequent encounter for fracture with routine healing

Billable / specific codeICD-10-CMPOA exempt

S32.699D is a billable, specific ICD-10-CM code for other specified fracture of unspecified ischium, subsequent encounter for fracture with routine healing. It is valid for submission on a claim.

Check S32.699D with the rest of the claim: free scrubber

7th character "D": subsequent encounter for fracture with routine healing

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 S32.699D

A category’s note binds every code beneath it.

Written on S32.6: Fracture of ischium

fracture of ischium 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 S32.699D

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 S32.699D

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

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S32.699D is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53065Billing and Coding: Outpatient Physical Therapy
A57765Billing and Coding: Major Joint Replacement (Hip and Knee)

Code history

Unchanged in every release from FY2024 to FY2027.