S52.365M
S52.365M — Nondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type I or II with nonunion
Billable / specific codeICD-10-CMPOA exemptleft
S52.365M is a billable, specific ICD-10-CM code for nondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type i or ii with nonunion. It is valid for submission on a claim.
7th character "M" — subsequent encounter for open fracture type I or II with nonunion
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
S52.365M 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
S52.365M 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 S52.365. If S52.365M is not quite right, the correct code is usually one of these.
- S52.365ANondisplaced segmental fracture of shaft of radius, left arm, initial encounter for closed fracture
- S52.365BNondisplaced segmental fracture of shaft of radius, left arm, initial encounter for open fracture type I or II
- S52.365CNondisplaced segmental fracture of shaft of radius, left arm, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S52.365DNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with routine healing
- S52.365ENondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type I or II with routine healing
- S52.365FNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S52.365GNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with delayed healing
- S52.365HNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type I or II with delayed healing
- S52.365JNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S52.365KNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with nonunion
- S52.365NNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S52.365PNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with malunion
- S52.365QNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type I or II with malunion
- S52.365RNondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S52.365SNondisplaced segmental fracture of shaft of radius, left arm, sequela
Questions about S52.365M
- Is S52.365M a billable ICD-10-CM code?
- Yes. S52.365M is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S52.365M 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).