S52.91XR
S52.91XR — Unspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
Billable / specific codeICD-10-CMPOA exemptright
S52.91XR is a billable, specific ICD-10-CM code for unspecified fracture of right 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
Risk adjustment
S52.91XR 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
S52.91XR is named in 2 Medicare coverage policies — 2 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
Related codes at this level
Codes that share S52.91. If S52.91XR is not quite right, the correct code is usually one of these.
- S52.91XAUnspecified fracture of right forearm, initial encounter for closed fracture
- S52.91XBUnspecified fracture of right forearm, initial encounter for open fracture type I or II
- S52.91XCUnspecified fracture of right forearm, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S52.91XDUnspecified fracture of right forearm, subsequent encounter for closed fracture with routine healing
- S52.91XEUnspecified fracture of right forearm, subsequent encounter for open fracture type I or II with routine healing
- S52.91XFUnspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S52.91XGUnspecified fracture of right forearm, subsequent encounter for closed fracture with delayed healing
- S52.91XHUnspecified fracture of right forearm, subsequent encounter for open fracture type I or II with delayed healing
- S52.91XJUnspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S52.91XKUnspecified fracture of right forearm, subsequent encounter for closed fracture with nonunion
- S52.91XMUnspecified fracture of right forearm, subsequent encounter for open fracture type I or II with nonunion
- S52.91XNUnspecified fracture of right forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S52.91XPUnspecified fracture of right forearm, subsequent encounter for closed fracture with malunion
- S52.91XQUnspecified fracture of right forearm, subsequent encounter for open fracture type I or II with malunion
- S52.91XSUnspecified fracture of right forearm, sequela
Questions about S52.91XR
- Is S52.91XR a billable ICD-10-CM code?
- Yes. S52.91XR is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S52.91XR 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).