S49.091K
S49.091K: Other physeal fracture of upper end of humerus, right arm, subsequent encounter for fracture with nonunion
Billable / specific codeICD-10-CMPOA exemptright
S49.091K is a billable, specific ICD-10-CM code for other physeal fracture of upper end of humerus, right arm, subsequent encounter for fracture with nonunion. It is valid for submission on a claim.
Check S49.091K with the rest of the claim: free scrubber7th character "K": subsequent encounter for fracture with nonunion
The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1
- A
- initial encounter for closed fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- P
- subsequent encounter for fracture with malunion
- S
- sequela
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S49.091K is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S49.091
- S49.091AOther physeal fracture of upper end of humerus, right arm, initial encounter for closed fracture
- S49.091DOther physeal fracture of upper end of humerus, right arm, subsequent encounter for fracture with routine healing
- S49.091GOther physeal fracture of upper end of humerus, right arm, subsequent encounter for fracture with delayed healing
- S49.091POther physeal fracture of upper end of humerus, right arm, subsequent encounter for fracture with malunion
- S49.091SOther physeal fracture of upper end of humerus, right arm, sequela