Is S52.111A a billable ICD-10-CM code?

Yes. S52.111A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S52.111A sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the elbow and forearm (S50-S59).

S52.111A

S52.111A — Torus fracture of upper end of right radius, initial encounter for closed fracture

Billable / specific codeICD-10-CMright

S52.111A is a billable, specific ICD-10-CM code for torus fracture of upper end of right radius, initial encounter for closed fracture. It is valid for submission on a claim.

7th character "A" — initial encounter for closed fracture

The appropriate 7th character is to be added to all codes in subcategory S52.11

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

S52.111A 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

S52.111A 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.

A57311Billing and Coding: Physical Therapy - Home Health

Related codes at this level

Codes that share S52.111. If S52.111A is not quite right, the correct code is usually one of these.

Questions about S52.111A

Is S52.111A a billable ICD-10-CM code?: Yes. S52.111A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S52.111A sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the elbow and forearm (S50-S59).