Excludes1 pair
S53- vs S53.2-
S53 and S53.2 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on S53.2
sprain of radial collateral ligament NOS (S53.43-)
S53
Dislocation and sprain of joints and ligaments of elbow
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S50-S59
Use when the record says
- avulsion of joint or ligament of elbow
- laceration of cartilage, joint or ligament of elbow
- sprain of cartilage, joint or ligament of elbow
- traumatic hemarthrosis of joint or ligament of elbow
- traumatic rupture of joint or ligament of elbow
- traumatic subluxation of joint or ligament of elbow
- traumatic tear of joint or ligament of elbow
S53.2
Traumatic rupture of radial collateral ligament
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S50-S59
Indexed under
- Rupture, ruptured › traumatic › ligament › radial collateral
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027