Is S53.004S a billable ICD-10-CM code?

Yes. S53.004S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S53.004S 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 S53.004S?

S53.004S 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 S53.004S (S53.0) and apply to it just the same.

S53.004S

S53.004S — Unspecified dislocation of right radial head, sequela

Billable / specific codeICD-10-CMPOA exemptright

S53.004S is a billable, specific ICD-10-CM code for unspecified dislocation of right radial head, sequela. It is valid for submission on a claim.

7th character "S" — sequela

The appropriate 7th character is to be added to each code from category S53

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S53.004S

These are not written on S53.004S, but they bind it: a note on a category applies to every code beneath it. Billing S53.004S with anything listed here is a denial.

Written on S53.0 — Subluxation and dislocation of radial head

Monteggia's fracture-dislocation (S52.27-)

Excludes2 inherited from the categories above S53.004S

Also inherited, and the opposite of Excludes1: these conditions are not part of S53.004S, but a patient can have both, so you may code both.

Written on S53 — Dislocation and sprain of joints and ligaments of elbow

strain of muscle, fascia and tendon at forearm level (S56.-)

Risk adjustment

S53.004S 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

S53.004S 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.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Code history

S53.004S 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 S53.004. If S53.004S is not quite right, the correct code is usually one of these.

Questions about S53.004S

Is S53.004S a billable ICD-10-CM code?: Yes. S53.004S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S53.004S 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 S53.004S?: S53.004S 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 S53.004S (S53.0) and apply to it just the same.