S59.099K — Other physeal fracture of lower end of ulna, unspecified arm, subsequent encounter for fracture with nonunion
Is S59.099K billable?
Yes, but S59.099K will trip a Medicare edit. S59.099K is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S59.099K 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.
S59.099K at a glance
| Code | S59.099K |
|---|---|
| Description | Other physeal fracture of lower end of ulna, unspecified arm, subsequent encounter for fracture with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "K" | subsequent encounter for fracture with nonunion |
What does the 7th character "K" mean in S59.099K?
In S59.099K, the 7th character K means subsequent encounter for fracture with nonunion. The 7th character is required for S59.099K to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS59.099A
- Dsubsequent encounter for fracture with routine healingS59.099D
- Gsubsequent encounter for fracture with delayed healingS59.099G
- Ksubsequent encounter for fracture with nonunionS59.099K
- Psubsequent encounter for fracture with malunionS59.099P
- SsequelaS59.099S
What Medicare edits apply to S59.099K?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S59.099K 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 S59.099K group to?
S59.099K sits in MDC 08 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.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S59.099K is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S59.099K listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S59.09, the nearest indexed parent of S59.099K. Use them to find the family, then select the specific code.
- Fracture, traumatic › ulna › lower end › physeal › specified NEC (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S59.099K to fully describe the condition. S59.099K 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 S59.099K, but a patient may have both at the same time. When documentation supports it, S59.099K and the excluded code may both be reported.
Excludes2 — not included here — inherited from S50-S59
The conditions below are not part of S59.099K, but a patient may have both at the same time. When documentation supports it, S59.099K and the excluded code may both be reported.
Excludes2 — not included here — inherited from S59
The conditions below are not part of S59.099K, but a patient may have both at the same time. When documentation supports it, S59.099K and the excluded code may both be reported.
- other and unspecified injuries of wrist and hand (S69.-)
How long has S59.099K existed?
S59.099K 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.