S89.099S — Other physeal fracture of upper end of unspecified tibia, sequela
S89.099S is a billable, specific ICD-10-CM code for other physeal fracture of upper end of unspecified tibia, 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 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
S89.099S 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
S89.099S is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53064Billing and Coding: Outpatient Occupational Therapy
Related codes at this level
Codes that share S89.099. If S89.099S is not quite right, the correct code is usually one of these.
- S89.099AOther physeal fracture of upper end of unspecified tibia, initial encounter for closed fracture
- S89.099DOther physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with routine healing
- S89.099GOther physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with delayed healing
- S89.099KOther physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with nonunion
- S89.099POther physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with malunion
Questions about S89.099S
- Is S89.099S a billable ICD-10-CM code?
- Yes. S89.099S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S89.099S 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).