Is S53.31XA a billable ICD-10-CM code?

Yes. S53.31XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S53.31XA 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 S53.31XA?

S53.31XA 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 S53.31XA (S53.3) and apply to it just the same.

S53.31XA

S53.31XA — Traumatic rupture of right ulnar collateral ligament, initial encounter

Billable / specific codeICD-10-CMright

S53.31XA is a billable, specific ICD-10-CM code for traumatic rupture of right ulnar collateral ligament, initial encounter. It is valid for submission on a claim.

7th character "A" — initial encounter

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 S53.31XA

These are not written on S53.31XA, but they bind it: a note on a category applies to every code beneath it. Billing S53.31XA with anything listed here is a denial.

Written on S53.3 — Traumatic rupture of ulnar collateral ligament

sprain of ulnar collateral ligament (S53.44-)

Excludes2 inherited from the categories above S53.31XA

Also inherited, and the opposite of Excludes1: these conditions are not part of S53.31XA, 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

S53.31XA 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

S53.31XA is named in 4 Medicare coverage policies — 4 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
A56787Billing and Coding: Nonvascular Extremity Ultrasound
A57311Billing and Coding: Physical Therapy - Home Health

Code history

S53.31XA 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 S53.31. If S53.31XA is not quite right, the correct code is usually one of these.

Questions about S53.31XA

Is S53.31XA a billable ICD-10-CM code?: Yes. S53.31XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S53.31XA 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 S53.31XA?: S53.31XA 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 S53.31XA (S53.3) and apply to it just the same.