Is S63.691S a billable ICD-10-CM code?

Yes. S63.691S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S63.691S sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the wrist, hand and fingers (S60-S69).

What cannot be coded together with S63.691S?

S63.691S 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 S63.691S (S63.6) and apply to it just the same.

S63.691S

S63.691S — Other sprain of left index finger, sequela

Billable / specific codeICD-10-CMPOA exemptleft

S63.691S is a billable, specific ICD-10-CM code for other sprain of left index finger, 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 S63

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S63.691S

These are not written on S63.691S, but they bind it: a note on a category applies to every code beneath it. Billing S63.691S with anything listed here is a denial.

Written on S63.6 — Other and unspecified sprain of finger(s)

traumatic rupture of ligament of finger at metacarpophalangeal and interphalangeal joint(s) (S63.4-)

Excludes2 inherited from the categories above S63.691S

Also inherited, and the opposite of Excludes1: these conditions are not part of S63.691S, but a patient can have both, so you may code both.

Written on S63 — Dislocation and sprain of joints and ligaments at wrist and hand level

strain of muscle, fascia and tendon of wrist and hand (S66.-)

Risk adjustment

S63.691S 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

S63.691S is named in 7 Medicare coverage policies — 7 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

Code history

S63.691S 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 S63.691. If S63.691S is not quite right, the correct code is usually one of these.

Questions about S63.691S

Is S63.691S a billable ICD-10-CM code?: Yes. S63.691S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S63.691S sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the wrist, hand and fingers (S60-S69).
What cannot be coded together with S63.691S?: S63.691S 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 S63.691S (S63.6) and apply to it just the same.