S34.119A: Complete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.119A is a billable, specific ICD-10-CM code for complete lesion of unspecified level of lumbar spinal cord, initial encounter. It is valid for submission on a claim.
Check S34.119A with the rest of the claim: free scrubber7th character "A": initial encounter
The appropriate 7th character is to be added to each code from category S34
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S34.119A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 182 Spinal Cord Disorders/Injuries0.478 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
S34.119A is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
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- A57188Billing and Coding: Routine Foot Care
- A57205Billing and Coding: Oximetry Services
- A57455Billing and Coding: Urodynamics
Code history
Unchanged in every release from FY2024 to FY2027.