S52.123B — Displaced fracture of head of unspecified radius, initial encounter for open fracture type I or II
Is S52.123B billable?
Yes, but S52.123B will trip a Medicare edit. S52.123B is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S52.123B 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
- S52.121BDisplaced fracture of head of right radius, initial encounter for open fracture type I or II
- S52.122BDisplaced fracture of head of left radius, initial encounter for open fracture type I or II
- S52.124BNondisplaced fracture of head of right radius, initial encounter for open fracture type I or II
- S52.125BNondisplaced fracture of head of left radius, initial encounter for open fracture type I or II
S52.123B at a glance
| Code | S52.123B |
|---|---|
| Description | Displaced fracture of head of unspecified radius, initial encounter for open fracture type I or II |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "B" | initial encounter for open fracture type I or II |
What does the 7th character "B" mean in S52.123B?
In S52.123B, the 7th character B means initial encounter for open fracture type I or II. The 7th character is required for S52.123B to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS52.123A
- Binitial encounter for open fracture type I or IIS52.123B
- Cinitial encounter for open fracture type IIIA, IIIB, or IIICS52.123C
- Dsubsequent encounter for closed fracture with routine healingS52.123D
- Esubsequent encounter for open fracture type I or II with routine healingS52.123E
- Fsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healingS52.123F
- Gsubsequent encounter for closed fracture with delayed healingS52.123G
- Hsubsequent encounter for open fracture type I or II with delayed healingS52.123H
- Jsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingS52.123J
- Ksubsequent encounter for closed fracture with nonunionS52.123K
- Msubsequent encounter for open fracture type I or II with nonunionS52.123M
- Nsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunionS52.123N
- Psubsequent encounter for closed fracture with malunionS52.123P
- Qsubsequent encounter for open fracture type I or II with malunionS52.123Q
- Rsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionS52.123R
- SsequelaS52.123S
What Medicare edits apply to S52.123B?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S52.123B 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 S52.123B group to?
S52.123B 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.
- 562Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCCmedical
- 563Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without MCCmedical
As a secondary diagnosis, S52.123B is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is S52.123B listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S52.12, the nearest indexed parent of S52.123B. Use them to find the family, then select the specific code.
- Fracture, traumatic › radius › upper end › head (abduction) (adduction) (separation)
- Fracture, traumatic › radius › upper end › head › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S52
The conditions below can never be reported together with S52.123B on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- traumatic amputation of forearm (S58.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S52.123B to fully describe the condition. S52.123B 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 S52.123B, but a patient may have both at the same time. When documentation supports it, S52.123B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S50-S59
The conditions below are not part of S52.123B, but a patient may have both at the same time. When documentation supports it, S52.123B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S52
The conditions below are not part of S52.123B, but a patient may have both at the same time. When documentation supports it, S52.123B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S52.1
The conditions below are not part of S52.123B, but a patient may have both at the same time. When documentation supports it, S52.123B and the excluded code may both be reported.
How long has S52.123B existed?
S52.123B 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.