S38.1XXA — Crushing injury of abdomen, lower back, and pelvis, initial encounter
S38.1XXA is a billable, specific ICD-10-CM code for crushing injury of abdomen, lower back, and pelvis, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S38
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- crushing injury of external genital organs (S38.0-)
Use additional code
Add a secondary code to capture the detail described below.
Risk adjustment
S38.1XXA 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
S38.1XXA is named in 4 Medicare coverage policies — 4 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
- A56459Billing and Coding: Debridement Services
- A56766Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
- A57206Billing and Coding: Lumbar MRI
Related codes at this level
Codes that share S38.1. If S38.1XXA is not quite right, the correct code is usually one of these.
Questions about S38.1XXA
- Is S38.1XXA a billable ICD-10-CM code?
- Yes. S38.1XXA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S38.1XXA 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).