Is S52.91 a billable ICD-10-CM code?

No. S52.91 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S52.91 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 S52.91?

S52.91 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 S52.91 (S52) and apply to it just the same.

S52.91

S52.91 — Unspecified fracture of right forearm

Non-billable headerICD-10-CMright

S52.91 is a non-billable header ICD-10-CM code for unspecified fracture of right forearm. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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 S52.91

These are not written on S52.91, but they bind it: a note on a category applies to every code beneath it. Billing S52.91 with anything listed here is a denial.

Written on S52 — Fracture of forearm

traumatic amputation of forearm (S58.-)

Excludes2 inherited from the categories above S52.91

Also inherited, and the opposite of Excludes1: these conditions are not part of S52.91, 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 S52.91

These codes carry an Excludes1 note pointing at S52.91. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S52.91 alone.

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

Risk adjustment

S52.91 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.

Code history

S52.91 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead S52.91

16 child codes. Green means billable.

Related codes at this level

Codes that share S52.9. If S52.91 is not quite right, the correct code is usually one of these.

Questions about S52.91

Is S52.91 a billable ICD-10-CM code?: No. S52.91 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S52.91 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 S52.91?: S52.91 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 S52.91 (S52) and apply to it just the same.