S62.126B — Nondisplaced fracture of lunate [semilunar], unspecified wrist, initial encounter for open fracture
Is S62.126B billable?
Yes, but S62.126B will trip a Medicare edit. S62.126B is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S62.126B 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
- S62.121BDisplaced fracture of lunate [semilunar], right wrist, initial encounter for open fracture
- S62.122BDisplaced fracture of lunate [semilunar], left wrist, initial encounter for open fracture
- S62.124BNondisplaced fracture of lunate [semilunar], right wrist, initial encounter for open fracture
- S62.125BNondisplaced fracture of lunate [semilunar], left wrist, initial encounter for open fracture
S62.126B at a glance
| Code | S62.126B |
|---|---|
| Description | Nondisplaced fracture of lunate [semilunar], unspecified wrist, initial encounter for open fracture |
| 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 |
What does the 7th character "B" mean in S62.126B?
In S62.126B, the 7th character B means initial encounter for open fracture. The 7th character is required for S62.126B to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS62.126A
- Binitial encounter for open fractureS62.126B
- Dsubsequent encounter for fracture with routine healingS62.126D
- Gsubsequent encounter for fracture with delayed healingS62.126G
- Ksubsequent encounter for fracture with nonunionS62.126K
- Psubsequent encounter for fracture with malunionS62.126P
- SsequelaS62.126S
What Medicare edits apply to S62.126B?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S62.126B 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 S62.126B group to?
S62.126B 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, S62.126B 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 S62.126B listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S62.12, the nearest indexed parent of S62.126B. Use them to find the family, then select the specific code.
- Fracture, traumatic › carpal bone › lunate (abduction) (adduction) (separation)
- Fracture, traumatic › carpal bone › lunate › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S62
The conditions below can never be reported together with S62.126B 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 wrist and hand (S68.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S62.126B to fully describe the condition. S62.126B 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 S62.126B, but a patient may have both at the same time. When documentation supports it, S62.126B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S60-S69
The conditions below are not part of S62.126B, but a patient may have both at the same time. When documentation supports it, S62.126B and the excluded code may both be reported.
Excludes2 — not included here — inherited from S62
The conditions below are not part of S62.126B, but a patient may have both at the same time. When documentation supports it, S62.126B and the excluded code may both be reported.
- fracture of distal parts of ulna and radius (S52.-)
Excludes2 — not included here — inherited from S62.1
The conditions below are not part of S62.126B, but a patient may have both at the same time. When documentation supports it, S62.126B and the excluded code may both be reported.
- fracture of scaphoid of wrist (S62.0-)
How long has S62.126B existed?
S62.126B 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.