S52.119G — Torus fracture of upper end of unspecified radius, subsequent encounter for fracture with delayed healing
S52.119G is a billable, specific ICD-10-CM code for torus fracture of upper end of unspecified radius, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
7th character "G" — subsequent encounter for fracture with delayed healing
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
S52.119G 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
S52.119G 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.
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S52.119. If S52.119G is not quite right, the correct code is usually one of these.
- S52.119ATorus fracture of upper end of unspecified radius, initial encounter for closed fracture
- S52.119DTorus fracture of upper end of unspecified radius, subsequent encounter for fracture with routine healing
- S52.119KTorus fracture of upper end of unspecified radius, subsequent encounter for fracture with nonunion
- S52.119PTorus fracture of upper end of unspecified radius, subsequent encounter for fracture with malunion
- S52.119STorus fracture of upper end of unspecified radius, sequela
Questions about S52.119G
- Is S52.119G a billable ICD-10-CM code?
- Yes. S52.119G is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S52.119G 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).