Is S79.011A a billable ICD-10-CM code?

Yes. S79.011A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S79.011A sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the hip and thigh (S70-S79).

S79.011A

S79.011A — Salter-Harris Type I physeal fracture of upper end of right femur, initial encounter for closed fracture

Billable / specific codeICD-10-CMright

S79.011A is a billable, specific ICD-10-CM code for salter-harris type i physeal fracture of upper end of right femur, initial encounter for closed fracture. It is valid for submission on a claim.

7th character "A" — initial encounter for closed fracture

The appropriate 7th character is to be added to each code from subcategories S79.0 and S79.1

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

S79.011A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 402 Hip Fracture/Dislocation0.467 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

S79.011A is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52465Knee Orthoses - Policy Article
A52465Knee Orthoses - Policy Article
A56777Billing and Coding: Total Joint Arthroplasty
A56796Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)

Related codes at this level

Codes that share S79.011. If S79.011A is not quite right, the correct code is usually one of these.

Questions about S79.011A

Is S79.011A a billable ICD-10-CM code?: Yes. S79.011A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S79.011A sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the hip and thigh (S70-S79).