S36.259D
S36.259D — Moderate laceration of unspecified part of pancreas, subsequent encounter
Billable / specific codeICD-10-CMPOA exempt
S36.259D is a billable, specific ICD-10-CM code for moderate laceration of unspecified part of pancreas, 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 S36
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S36.259D 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
S36.259D is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Related codes at this level
Codes that share S36.259. If S36.259D is not quite right, the correct code is usually one of these.
Questions about S36.259D
- Is S36.259D a billable ICD-10-CM code?
- Yes. S36.259D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S36.259D 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).