S52.255E
S52.255E — Nondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type I or II with routine healing
Billable / specific codeICD-10-CMPOA exemptleft
S52.255E is a billable, specific ICD-10-CM code for nondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type i or ii with routine healing. It is valid for submission on a claim.
7th character "E" — subsequent encounter for open fracture type I or II with routine healing
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
S52.255E 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
S52.255E is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share S52.255. If S52.255E is not quite right, the correct code is usually one of these.
- S52.255ANondisplaced comminuted fracture of shaft of ulna, left arm, initial encounter for closed fracture
- S52.255BNondisplaced comminuted fracture of shaft of ulna, left arm, initial encounter for open fracture type I or II
- S52.255CNondisplaced comminuted fracture of shaft of ulna, left arm, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S52.255DNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for closed fracture with routine healing
- S52.255FNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S52.255GNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for closed fracture with delayed healing
- S52.255HNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type I or II with delayed healing
- S52.255JNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S52.255KNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for closed fracture with nonunion
- S52.255MNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type I or II with nonunion
- S52.255NNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S52.255PNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for closed fracture with malunion
- S52.255QNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type I or II with malunion
- S52.255RNondisplaced comminuted fracture of shaft of ulna, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S52.255SNondisplaced comminuted fracture of shaft of ulna, left arm, sequela
Questions about S52.255E
- Is S52.255E a billable ICD-10-CM code?
- Yes. S52.255E is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S52.255E 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).