Is S52.90XR a billable ICD-10-CM code?

Yes. S52.90XR is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S52.90XR 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).

What cannot be coded together with S52.90XR?

S52.90XR carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S52.90XR (S52) and apply to it just the same.

S52.90XR

S52.90XR — Unspecified fracture of unspecified forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

Billable / specific codeICD-10-CMPOA exempt

S52.90XR is a billable, specific ICD-10-CM code for unspecified fracture of unspecified forearm, 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

Excludes1 inherited from the categories above S52.90XR

These are not written on S52.90XR, but they bind it: a note on a category applies to every code beneath it. Billing S52.90XR with anything listed here is a denial.

Written on S52 — Fracture of forearm

traumatic amputation of forearm (S58.-)

Excludes2 inherited from the categories above S52.90XR

Also inherited, and the opposite of Excludes1: these conditions are not part of S52.90XR, but a patient can have both, so you may code both.

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 S52.90XR

These codes carry an Excludes1 note pointing at S52.90XR. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S52.90XR alone.

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

Risk adjustment

S52.90XR 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

S52.90XR 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.

A53058Billing and Coding: Home Health Physical Therapy

Code history

S52.90XR has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S52.90. If S52.90XR is not quite right, the correct code is usually one of these.

Questions about S52.90XR

Is S52.90XR a billable ICD-10-CM code?: Yes. S52.90XR is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S52.90XR 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).
What cannot be coded together with S52.90XR?: S52.90XR carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S52.90XR (S52) and apply to it just the same.