Is S33.8XXD a billable ICD-10-CM code?

Yes. S33.8XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S33.8XXD 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).

What cannot be coded together with S33.8XXD?

S33.8XXD carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S33.8XXD (S33) and apply to it just the same.

S33.8XXD

S33.8XXD — Sprain of other parts of lumbar spine and pelvis, subsequent encounter

Billable / specific codeICD-10-CMPOA exempt

S33.8XXD is a billable, specific ICD-10-CM code for sprain of other parts of lumbar spine and pelvis, subsequent encounter. It is valid for submission on a claim.

7th character "D" — subsequent encounter

The appropriate 7th character is to be added to each code from category S33

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S33.8XXD

These are not written on S33.8XXD, but they bind it: a note on a category applies to every code beneath it. Billing S33.8XXD with anything listed here is a denial.

Written on S33 — Dislocation and sprain of joints and ligaments of lumbar spine and pelvis

nontraumatic rupture or displacement of lumbar intervertebral disc NOS (M51.-)
obstetric damage to pelvic joints and ligaments (O71.6)

Excludes2 inherited from the categories above S33.8XXD

Also inherited, and the opposite of Excludes1: these conditions are not part of S33.8XXD, but a patient can have both, so you may code both.

Written on S33 — Dislocation and sprain of joints and ligaments of lumbar spine and pelvis

dislocation and sprain of joints and ligaments of hip (S73.-)
strain of muscle of lower back and pelvis (S39.01-)

Risk adjustment

S33.8XXD 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

S33.8XXD is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A57206Billing and Coding: Lumbar MRI
A57311Billing and Coding: Physical Therapy - Home Health

Code history

S33.8XXD has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S33.8. If S33.8XXD is not quite right, the correct code is usually one of these.

Questions about S33.8XXD

Is S33.8XXD a billable ICD-10-CM code?: Yes. S33.8XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S33.8XXD 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).
What cannot be coded together with S33.8XXD?: S33.8XXD carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S33.8XXD (S33) and apply to it just the same.