S52.691M

S52.691M: Other fracture of lower end of right ulna, subsequent encounter for open fracture type I or II with nonunion

Billable / specific codeICD-10-CMPOA exemptright

S52.691M is a billable, specific ICD-10-CM code for other fracture of lower end of right ulna, subsequent encounter for open fracture type i or ii with nonunion. It is valid for submission on a claim.

Check S52.691M with the rest of the claim: free scrubber

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

Excludes1 inherited from the categories above S52.691M

A category’s note binds every code beneath it.

Written on S52: Fracture of forearm

traumatic amputation of forearm (S58.-)

Excludes2 inherited from the categories above S52.691M

Not part of this code, but both may be coded when both are present.

Written on S52: Fracture of forearm

fracture at wrist and hand level (S62.-)
periprosthetic fracture around internal prosthetic elbow joint (M97.4)

Other codes that can never be billed with S52.691M

Their own Excludes1 notes name this code, so the conflict is not listed above.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S51Open wound of elbow and forearm

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S52.691M is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Code history

Unchanged in every release from FY2024 to FY2027.