S52.209R
S52.209R — Unspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
Billable / specific codeICD-10-CMPOA exempt
S52.209R is a billable, specific ICD-10-CM code for unspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type iiia, iiib, or iiic with malunion. It is valid for submission on a claim.
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
Risk adjustment
S52.209R 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
S52.209R 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 S52.209. If S52.209R is not quite right, the correct code is usually one of these.
- S52.209AUnspecified fracture of shaft of unspecified ulna, initial encounter for closed fracture
- S52.209BUnspecified fracture of shaft of unspecified ulna, initial encounter for open fracture type I or II
- S52.209CUnspecified fracture of shaft of unspecified ulna, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S52.209DUnspecified fracture of shaft of unspecified ulna, subsequent encounter for closed fracture with routine healing
- S52.209EUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type I or II with routine healing
- S52.209FUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S52.209GUnspecified fracture of shaft of unspecified ulna, subsequent encounter for closed fracture with delayed healing
- S52.209HUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type I or II with delayed healing
- S52.209JUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S52.209KUnspecified fracture of shaft of unspecified ulna, subsequent encounter for closed fracture with nonunion
- S52.209MUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type I or II with nonunion
- S52.209NUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S52.209PUnspecified fracture of shaft of unspecified ulna, subsequent encounter for closed fracture with malunion
- S52.209QUnspecified fracture of shaft of unspecified ulna, subsequent encounter for open fracture type I or II with malunion
- S52.209SUnspecified fracture of shaft of unspecified ulna, sequela
Questions about S52.209R
- Is S52.209R a billable ICD-10-CM code?
- Yes. S52.209R is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S52.209R 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).