S50-S59 — Injuries to the elbow and forearm
ICD-10-CM codes S50-S59 cover injuries to the elbow and forearm, within injury, poisoning and certain other consequences of external causes. The block holds 5,237 codes across 10 categories, of which 4,362 are billable and 875 are header codes that cannot be submitted on a claim. 5,237 of them (100%) require a 7th character.
The 7th character in S50-S59
A code in this block is not complete without its 7th character, and a missing one is a rejected claim rather than a denied one: the clearinghouse never passes it on. 5,237 of the 5,237 codes here take one.
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment in S50-S59
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 405 Traumatic Amputations and Complications
What else to watch in S50-S59
- 3,408 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 3,396 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in S50-S59
- S50Superficial injury of elbow and forearm
- S51Open wound of elbow and forearm
- S52Fracture of forearm
- S53Dislocation and sprain of joints and ligaments of elbow
- S54Injury of nerves at forearm level
- S55Injury of blood vessels at forearm level
- S56Injury of muscle, fascia and tendon at forearm level
- S57Crushing injury of elbow and forearm
- S58Traumatic amputation of elbow and forearm
- S59Other and unspecified injuries of elbow and forearm