Is S41.152D a billable ICD-10-CM code?

Yes. S41.152D is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S41.152D sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).

What cannot be coded together with S41.152D?

S41.152D 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 S41.152D (S41.15, S41) and apply to it just the same.

S41.152D

S41.152D — Open bite of left upper arm, subsequent encounter

Billable / specific codeICD-10-CMPOA exemptleft

S41.152D is a billable, specific ICD-10-CM code for open bite of left upper arm, 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 S41

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S41.152D

These are not written on S41.152D, but they bind it: a note on a category applies to every code beneath it. Billing S41.152D with anything listed here is a denial.

Written on S41.15 — Open bite of upper arm

superficial bite of upper arm (S40.87)

Written on S41 — Open wound of shoulder and upper arm

traumatic amputation of shoulder and upper arm (S48.-)

Excludes2 inherited from the categories above S41.152D

Also inherited, and the opposite of Excludes1: these conditions are not part of S41.152D, but a patient can have both, so you may code both.

Written on S41 — Open wound of shoulder and upper arm

open fracture of shoulder and upper arm (S42.- with 7th character B or C)

Risk adjustment

S41.152D 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

S41.152D is named in 8 Medicare coverage policies — 8 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
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
A56459Billing and Coding: Debridement Services

Code history

S41.152D 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 S41.152. If S41.152D is not quite right, the correct code is usually one of these.

Questions about S41.152D

Is S41.152D a billable ICD-10-CM code?: Yes. S41.152D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S41.152D sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).
What cannot be coded together with S41.152D?: S41.152D 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 S41.152D (S41.15, S41) and apply to it just the same.