2027 ICD-10-CM Diagnosis Code S24.109AUnspecified injury at unspecified level of thoracic spinal cord, initial encounter

ICD-10-CM Codes›S00–T88›S20-S29›S24

ICD-10-CM S24.109A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S24.109A is a billable ICD-10-CM diagnosis code for unspecified injury at unspecified level of thoracic spinal cord, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 52 through 53, 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spinal cord injury (SCI), initial encounter.

For Medicare Advantage risk adjustment, S24.109A maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries) under the V28 model, adding a risk factor of about 0.478 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
S24.109A
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified injury at unspecified level of thoracic spinal cord, initial encounter
Short Description
Unsp injury at unsp level of thoracic spinal cord, init
Parent Code
S24.109
Unspecified injury at unspecified level of thoracic spinal cord

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS20-S29Injuries to the thorax
CategoryS24Injury of nerves and spinal cord at thorax level
This CodeS24.109AUnspecified injury at unspecified level of thoracic spinal cord, initial encounter

Medicare Risk Adjustment (HCC)Billing

S24.109A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 182— Spinal Cord Disorders/Injuries
Payment HCC · PY 2027 one of 251 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.478
community, non-dual, aged · ranges 0.270–0.478 across segments
Hierarchy
Superseded by HCC 180, HCC 181, HCC 191, and HCC 192
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 72
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 72 · ESRD (V21): HCC 72 · ESRD (V24): HCC 72
ESRD V21 weights: 0.102 dialysis, 0.256–0.456 functioning graft · ESRD V24 weights: 0.099 dialysis, 0.222–0.523 functioning graft
Part D (RxHCC)
Not mapped
S24.109A does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Central cord syndrome of thoracic spinal cord due to injury of spinal cord at T7 - T12 level
  • Central cord syndrome of thoracic spinal cord due to traumatic injury
  • Closed fracture of T1-T6 level with spinal cord injury
  • Closed fracture of thoracic region with spinal cord injury
  • Fracture of thoracic spine with cord lesion
  • Injury of nerves and spinal cord at thorax level
  • Injury of peripheral nerve of thorax
  • Injury of thoracic spinal cord
  • Injury of thoracic spine
  • Laceration of spinal cord
  • Laceration of thoracic spinal cord
  • Lesion of thoracic spinal cord due to closed dislocation of joint of thoracic spine
  • Lesion of thoracic spinal cord due to open dislocation of joint of thoracic spine
  • Lesion of thoracic spinal cord due to subluxation of joint of thoracic spine
  • Open dislocation thoracic spine
  • Open fracture of T7-T12 level with spinal cord injury
  • Open fracture of thoracic spine with spinal cord injury
  • Thoracic cord injury without spinal bone injury
  • Thoracic spinal cord lesion due to thoracic spinal dislocation

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Injury of nerves and spinal cord at thorax level (S24). Use the following options for the applicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to S24.109A: its own notes plus those printed at S24, block S20-S29, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block S20-S29 Injuries to the thorax applies to 1,602 codes
  • injuries of breast
  • injuries of chest (wall)
  • injuries of interscapular area

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From S24 Injury of nerves and spinal cord at thorax level applies to 93 codes
  • injury of brachial plexus (S14.3)
From Block S20-S29 Injuries to the thorax applies to 1,602 codes
  • burns and corrosions (T20-T32)
  • effects of foreign body in bronchus (T17.5)
  • effects of foreign body in esophagus (T18.1)
  • effects of foreign body in lung (T17.8)
  • effects of foreign body in trachea (T17.4)
  • frostbite (T33-T34)
  • injuries of axilla
  • injuries of clavicle
  • injuries of scapular region
  • injuries of shoulder
  • insect bite or sting, venomous (T63.4)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From S24 Injury of nerves and spinal cord at thorax level applies to 93 codes
  • any associated:
  • fracture of thoracic vertebra (S22.0-)
  • open wound of thorax (S21.-)
  • transient paralysis (R29.5)

Notes

General instructions on how these codes are used.

From S24 Injury of nerves and spinal cord at thorax level applies to 93 codes
  • Code to highest level of thoracic spinal cord injury
  • Injuries to the spinal cord (S24.0 and S24.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given.
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From S24 Injury of nerves and spinal cord at thorax level applies to 93 codes
  • The appropriate 7th character is to be added to each code from category S24
Values for category S24 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name S24.109A, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming S24.109A: they are not reported together with it, unless the two conditions are unrelated.

  • G83.8 Other specified paralytic syndromes
    paralytic syndromes due to current spinal cord injury-code to spinal cord injury (S14, S24, S34) names S24, which includes this code

Code First 2

These codes say to code first a condition named in the note, and S24.109A is one of the conditions named.

  • R29.5 Transient paralysis
    any associated spinal cord injury (S14.0, S14.1-, S24.0, S24.1-, S34.0-, S34.1-) names S24.1-, which includes this code
  • S22 Fracture of rib(s), sternum and thoracic spine
    if applicable, spinal cord injury (S24.0-, S24.1-) names S24.1-, which includes this code

Code Also 4

These codes say S24.109A may also be needed to fully describe the condition. The note gives no sequencing direction.

  • S21 Open wound of thorax
    spinal cord injury (S24.0-, S24.1-) names S24.1-, which includes this code
  • S23.1 Subluxation and dislocation of thoracic vertebra
    spinal cord injury (S24.0-, S24.1-) names S24.1-, which includes this code
  • S31 Open wound of abdomen, lower back, pelvis and external genitals
    spinal cord injury (S24.0, S24.1-, S34.0-, S34.1-) names S24.1-, which includes this code
  • S33.1 Subluxation and dislocation of lumbar vertebra
    spinal cord injury (S24.0, S24.1-, S34.0-, S34.1-) names S24.1-, which includes this code

Notes 1

These notes mention S24.109A.

  • S24 Injury of nerves and spinal cord at thorax level
    Injuries to the spinal cord (S24.0 and S24.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given. names S24.1, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ009
Spinal cord injury (SCI), initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Spinal Cord Injuries

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back and forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures (breaks) or dislocates your vertebrae, the bone disks that make up your spine.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert S24.109A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
952.9 Spinal cord injury NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S24.109AOverview

Is S24.109A a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified injury at unspecified level of thoracic spinal cord, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S24.109A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified injury at unspecified level of thoracic spinal cord, such as an emergency visit or first evaluation.

What MS-DRG does S24.109A group to?

When unspecified injury at unspecified level of thoracic spinal cord, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 53, 963, 52, with relative weights from 0.9723 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of S24.109A?

Under the General Equivalence Mappings, unspecified injury at unspecified level of thoracic spinal cord, initial encounter converts to ICD-9-CM 952.9 (spinal cord injury NOS). The mapping is approximate, so confirm the match fits the documentation.

What HCC is S24.109A?

S24.109A (unspecified injury at unspecified level of thoracic spinal cord, initial encounter) maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries), commonly written as HCC 182, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 72 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does S24.109A risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, S24.109A adds a risk adjustment factor of about 0.478 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.270 to 0.478 depending on the payment segment). A more severe related category (HCC 180, HCC 181, HCC 191, and HCC 192) supersedes it when both are reported. See the full factor table on the HCC 182 category page.