Is S89.012A a billable ICD-10-CM code?

Yes. S89.012A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S89.012A 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).

S89.012A

S89.012A — Salter-Harris Type I physeal fracture of upper end of left tibia, initial encounter for closed fracture

Billable / specific codeICD-10-CMleft

S89.012A is a billable, specific ICD-10-CM code for salter-harris type i physeal fracture of upper end of left 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

S89.012A 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

S89.012A 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
A57311Billing and Coding: Physical Therapy - Home Health

Related codes at this level

Codes that share S89.012. If S89.012A is not quite right, the correct code is usually one of these.

Questions about S89.012A

Is S89.012A a billable ICD-10-CM code?: Yes. S89.012A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S89.012A 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).