S89.001A — Unspecified physeal fracture of upper end of right tibia, initial encounter for closed fracture
S89.001A is a billable, specific ICD-10-CM code for unspecified physeal fracture of upper end of right tibia, 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 S89.0, S89.1, S89.2, and S89.3
- 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
S89.001A 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
S89.001A 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.
- A52465Knee Orthoses - Policy Article
- A52465Knee Orthoses - Policy Article
- A56777Billing and Coding: Total Joint Arthroplasty
- A57685Billing and Coding: Total Knee Arthroplasty
Related codes at this level
Codes that share S89.001. If S89.001A is not quite right, the correct code is usually one of these.
- S89.001DUnspecified physeal fracture of upper end of right tibia, subsequent encounter for fracture with routine healing
- S89.001GUnspecified physeal fracture of upper end of right tibia, subsequent encounter for fracture with delayed healing
- S89.001KUnspecified physeal fracture of upper end of right tibia, subsequent encounter for fracture with nonunion
- S89.001PUnspecified physeal fracture of upper end of right tibia, subsequent encounter for fracture with malunion
- S89.001SUnspecified physeal fracture of upper end of right tibia, sequela
Questions about S89.001A
- Is S89.001A a billable ICD-10-CM code?
- Yes. S89.001A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S89.001A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).