ICDcodes.org
FY2027

S59.109P — Unspecified physeal fracture of upper end of radius, unspecified arm, subsequent encounter for fracture with malunion

BillableUnspecifiedCC

Is S59.109P billable?

Yes, but S59.109P will trip a Medicare edit. S59.109P is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S59.109P 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.

S59.109P at a glance

CodeS59.109P
DescriptionUnspecified physeal fracture of upper end of radius, unspecified arm, subsequent encounter for fracture with malunion
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "P"subsequent encounter for fracture with malunion

What does the 7th character "P" mean in S59.109P?

In S59.109P, the 7th character P means subsequent encounter for fracture with malunion. The 7th character is required for S59.109P to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to S59.109P?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S59.109P directly.

Unspecified — a laterality-specific code exists — MCE edit 20

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 S59.109P group to?

S59.109P 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, S59.109P is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is S59.109P listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S59.10, the nearest indexed parent of S59.109P. Use them to find the family, then select the specific code.

  • Fracture, traumatic › radius › upper end › physeal (abduction) (adduction) (separation)

Use additional code — inherited from Chapter 19

Report an additional code alongside S59.109P to fully describe the condition. S59.109P 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 S59.109P, but a patient may have both at the same time. When documentation supports it, S59.109P and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from S50-S59

The conditions below are not part of S59.109P, but a patient may have both at the same time. When documentation supports it, S59.109P and the excluded code may both be reported.

  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of wrist and hand (S60-S69)
  • insect bite or sting, venomous (T63.4)

Excludes2 — not included here — inherited from S59

The conditions below are not part of S59.109P, but a patient may have both at the same time. When documentation supports it, S59.109P and the excluded code may both be reported.

  • other and unspecified injuries of wrist and hand (S69.-)

How long has S59.109P existed?

S59.109P 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.