S37.059A — Moderate laceration of unspecified kidney, initial encounter
Is S37.059A billable?
Yes, but S37.059A will trip a Medicare edit. S37.059A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S37.059A 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.
S37.059A at a glance
| Code | S37.059A |
|---|---|
| Description | Moderate laceration of unspecified kidney, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in S37.059A?
In S37.059A, the 7th character A means initial encounter. The 7th character is required for S37.059A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S37.059A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S37.059A 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 S37.059A group to?
S37.059A sits in MDC 11 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 698Other Kidney and Urinary Tract Diagnoses with MCCmedical
- 699Other Kidney and Urinary Tract Diagnoses with CCmedical
- 700Other Kidney and Urinary Tract Diagnoses without CC/MCCmedical
As a secondary diagnosis, S37.059A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S37.059A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S37.05, the nearest indexed parent of S37.059A. Use them to find the family, then select the specific code.
- Laceration › kidney › moderate
Excludes1 — never code together — inherited from S37
The conditions below can never be reported together with S37.059A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- obstetric trauma to pelvic organs (O71.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S37.059A to fully describe the condition. S37.059A 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 S37.059A, but a patient may have both at the same time. When documentation supports it, S37.059A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S30-S39
The conditions below are not part of S37.059A, but a patient may have both at the same time. When documentation supports it, S37.059A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S37
The conditions below are not part of S37.059A, but a patient may have both at the same time. When documentation supports it, S37.059A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S37.0
The conditions below are not part of S37.059A, but a patient may have both at the same time. When documentation supports it, S37.059A and the excluded code may both be reported.
- acute kidney injury (nontraumatic) (N17.9)
Code also — inherited from S37
Two codes may be needed to describe the condition fully. Whether S37.059A is sequenced first depends on the reason for the encounter.
- any associated open wound (S31.-)
How long has S37.059A existed?
S37.059A 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.