S32.616A — Nondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture
Is S32.616A billable?
Yes, but S32.616A will trip a Medicare edit. S32.616A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S32.616A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
More specific alternatives
- S32.611ADisplaced avulsion fracture of right ischium, initial encounter for closed fracture
- S32.612ADisplaced avulsion fracture of left ischium, initial encounter for closed fracture
- S32.614ANondisplaced avulsion fracture of right ischium, initial encounter for closed fracture
- S32.615ANondisplaced avulsion fracture of left ischium, initial encounter for closed fracture
S32.616A at a glance
| Code | S32.616A |
|---|---|
| Description | Nondisplaced avulsion fracture of unspecified ischium, initial encounter for closed fracture |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter for closed fracture |
What does the 7th character "A" mean in S32.616A?
In S32.616A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S32.616A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S32.616A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S32.616A directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does S32.616A group to?
S32.616A sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 535Fractures of Hip and Pelvis with MCCmedical
- 536Fractures of Hip and Pelvis without MCCmedical
As a secondary diagnosis, S32.616A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is S32.616A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S32.61, the nearest indexed parent of S32.616A. Use them to find the family, then select the specific code.
- Fracture, traumatic › ischium › avulsion (abduction) (adduction) (separation)
- Fracture, traumatic › ischium › avulsion › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S32
The conditions below can never be reported together with S32.616A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- transection of abdomen (S38.3)
Excludes1 — never code together — inherited from S32.6
The conditions below can never be reported together with S32.616A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- fracture of ischium with associated disruption of pelvic ring (S32.8-)
Code first — inherited from S32
The underlying condition below must be sequenced before S32.616A. S32.616A describes a manifestation and cannot be the principal or first-listed diagnosis.
- any associated spinal cord and spinal nerve injury (S34.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S32.616A to fully describe the condition. S32.616A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of S32.616A, but a patient may have both at the same time. When documentation supports it, S32.616A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S30-S39
The conditions below are not part of S32.616A, but a patient may have both at the same time. When documentation supports it, S32.616A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S32
The conditions below are not part of S32.616A, but a patient may have both at the same time. When documentation supports it, S32.616A and the excluded code may both be reported.
- fracture of hip NOS (S72.0-)
How long has S32.616A existed?
S32.616A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.