S52.109R

S52.109R: Unspecified fracture of upper end of unspecified radius, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

Billable / specific codeICD-10-CMPOA exempt

S52.109R is a billable, specific ICD-10-CM code for unspecified fracture of upper end of unspecified radius, subsequent encounter for open fracture type iiia, iiib, or iiic with malunion. It is valid for submission on a claim.

Check S52.109R with the rest of the claim: free scrubber

7th character "R": subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

The appropriate 7th character is to be added to all codes from category S52

A: initial encounter for closed fracture
B: initial encounter for open fracture type I or II
C: initial encounter for open fracture type IIIA, IIIB, or IIIC
D: subsequent encounter for closed fracture with routine healing
E: subsequent encounter for open fracture type I or II with routine healing
F: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
G: subsequent encounter for closed fracture with delayed healing
H: subsequent encounter for open fracture type I or II with delayed healing
J: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
K: subsequent encounter for closed fracture with nonunion
M: subsequent encounter for open fracture type I or II with nonunion
N: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
P: subsequent encounter for closed fracture with malunion
Q: subsequent encounter for open fracture type I or II with malunion
R: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S: sequela

Excludes1 inherited from the categories above S52.109R

A category’s note binds every code beneath it.

Written on S52: Fracture of forearm

traumatic amputation of forearm (S58.-)

Excludes2 inherited from the categories above S52.109R

Not part of this code, but both may be coded when both are present.

Written on S52.1: Fracture of upper end of radius

physeal fractures of upper end of radius (S59.2-)
fracture of shaft of radius (S52.3-)

Written on S52: Fracture of forearm

fracture at wrist and hand level (S62.-)
periprosthetic fracture around internal prosthetic elbow joint (M97.4)

Other codes that can never be billed with S52.109R

Their own Excludes1 notes name this code, so the conflict is not listed above.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S51Open wound of elbow and forearm

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S52.109R is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53065Billing and Coding: Outpatient Physical Therapy

Code history

Unchanged in every release from FY2024 to FY2027.