Is ICD-10-CM code S52 billable?

No, S52 (Fracture of forearm) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code S52 belong to?

S52 belongs to Chapter 19 of the ICD-10-CM tabular list: S00–T88 (Injury, Poisoning and Certain Other Consequences of External Causes).

S52Not billable, use a more specific code below

Fracture of forearm

In Injuries to the elbow and forearm (S50-S59), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes

2,796 billable codes under S52: 336 are an MCC, 1,185 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes1: not coded here, use a different code

traumatic amputation of forearm (S58.-)

Excludes2: not included here, code separately if applicable

fracture at wrist and hand level (S62.-)
periprosthetic fracture around internal prosthetic elbow joint (M97.4)

Also applies, from Injuries to the elbow and forearm (S50-S59)

These notes sit on S50-S59 and apply to every code under it, including S52.

Excludes2: not included here, code separately if applicable

burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of wrist and hand (S60-S69)
insect bite or sting, venomous (T63.4)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.19.c Coding of Traumatic Fractures (page 79), covers S52
Code fractures by site; default to closed and displaced when not specified. Use initial 7th characters during active treatment and subsequent ones during healing, not aftercare Z codes; use M80 for osteoporotic fractures from minor trauma.

Codes under S52

S52 can't be used on a claim. Pick a billable code below; grey headings group them.

S52 MS-DRGs

As the principal diagnosis, the billable codes under S52 group to these 11 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 559 Aftercare, Musculoskeletal System and Connective Tissue with MCC (1230 of 2796 codes)
DRG 560 Aftercare, Musculoskeletal System and Connective Tissue with CC (1230 of 2796 codes)
DRG 561 Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC (1230 of 2796 codes)
DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC (1044 of 2796 codes)
DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC (1044 of 2796 codes)
DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (1044 of 2796 codes)
DRG 562 Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCC (522 of 2796 codes)
DRG 563 Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without MCC (522 of 2796 codes)
DRG 963 Other Multiple Significant Trauma with MCC (522 of 2796 codes)
DRG 964 Other Multiple Significant Trauma with CC (522 of 2796 codes)
DRG 965 Other Multiple Significant Trauma without CC/MCC (522 of 2796 codes)

Other codes that refer to S52

Notes on these codes point to S52.

M84.3 Excludes1: traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
M84.4 Excludes1: traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
S51 Excludes1: open fracture of elbow and forearm (S52.- with open fracture 7th character)
S62 Excludes2: fracture of distal parts of ulna and radius (S52.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Fractures

A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.