S56.404A — Unspecified injury of extensor muscle, fascia and tendon of left middle finger at forearm level, initial encounter
S56.404A is a billable, specific ICD-10-CM code for unspecified injury of extensor muscle, fascia and tendon of left middle finger at forearm level, 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 S56
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S56.404A 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
S56.404A 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 S56.404. If S56.404A is not quite right, the correct code is usually one of these.
Questions about S56.404A
- Is S56.404A a billable ICD-10-CM code?
- Yes. S56.404A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S56.404A 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).