S75.809A — Unspecified injury of other blood vessels at hip and thigh level, unspecified leg, initial encounter
Is S75.809A billable?
Yes, but S75.809A will trip a Medicare edit. S75.809A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S75.809A 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
S75.809A at a glance
| Code | S75.809A |
|---|---|
| Description | Unspecified injury of other blood vessels at hip and thigh level, unspecified leg, 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 S75.809A?
In S75.809A, the 7th character A means initial encounter. The 7th character is required for S75.809A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S75.809A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S75.809A 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 S75.809A group to?
S75.809A sits in MDC 21 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.
- 913Traumatic Injury with MCCmedical
- 914Traumatic Injury without MCCmedical
As a secondary diagnosis, S75.809A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S75.809A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S75.80, the nearest indexed parent of S75.809A. Use them to find the family, then select the specific code.
- Injury › blood vessel NEC › hip › specified › site NEC
Use additional code — inherited from Chapter 19
Report an additional code alongside S75.809A to fully describe the condition. S75.809A 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 S75.809A, but a patient may have both at the same time. When documentation supports it, S75.809A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S70-S79
The conditions below are not part of S75.809A, but a patient may have both at the same time. When documentation supports it, S75.809A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S75
The conditions below are not part of S75.809A, but a patient may have both at the same time. When documentation supports it, S75.809A and the excluded code may both be reported.
Code also — inherited from S75
Two codes may be needed to describe the condition fully. Whether S75.809A is sequenced first depends on the reason for the encounter.
- any associated open wound (S71.-)
How long has S75.809A existed?
S75.809A 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.