S59.101S — Unspecified physeal fracture of upper end of radius, right arm, sequela
S59.101S is a billable, specific ICD-10-CM code for unspecified physeal fracture of upper end of radius, right arm, 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 subcategories S59.0, S59.1, and S59.2
- A
- initial encounter for closed fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- P
- subsequent encounter for fracture with malunion
- S
- sequela
Risk adjustment
S59.101S 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
S59.101S 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.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S59.101. If S59.101S is not quite right, the correct code is usually one of these.
- S59.101AUnspecified physeal fracture of upper end of radius, right arm, initial encounter for closed fracture
- S59.101DUnspecified physeal fracture of upper end of radius, right arm, subsequent encounter for fracture with routine healing
- S59.101GUnspecified physeal fracture of upper end of radius, right arm, subsequent encounter for fracture with delayed healing
- S59.101KUnspecified physeal fracture of upper end of radius, right arm, subsequent encounter for fracture with nonunion
- S59.101PUnspecified physeal fracture of upper end of radius, right arm, subsequent encounter for fracture with malunion
Questions about S59.101S
- Is S59.101S a billable ICD-10-CM code?
- Yes. S59.101S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S59.101S 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).