2027 ICD-10-CM Diagnosis Code S32.432ADisplaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture
ICD-10-CM Codes›S00–T88›S30-S39›S32
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 402
- 7th Character A — Initial Encounter for Closed Fracture
- Not Chronic
S32.432A is a billable ICD-10-CM diagnosis code for displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture. The 7th character A means initial encounter for closed fracture, 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 521 through 522, 535 through 536, 963 through 965. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 467 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of torso, initial encounter.
For Medicare Advantage risk adjustment, S32.432A maps to CMS-HCC Category 402 (Hip Fracture/Dislocation) under the V28 model, adding a risk factor of about 0.467 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when S32.432A is part of the patient record.
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient’s on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.
Osteoporosis Management in Women Who Had a Fracture
High Priority: NO
Measure Type: Process
Submission Methods: Claims, Registry
Description: The percentage of women 50-85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the 180 days after the fracture.
Medicare Risk Adjustment (HCC)Billing
S32.432A 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.
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.
- Closed fracture acetabulum, anterior column
- Closed fracture of anterior column and posterior column of acetabulum
- Closed fracture of anterior column and posterior column of left acetabulum
- Closed fracture of anterior column of left acetabulum
- Closed fracture of left acetabulum
- Closed fracture of posterior column of left acetabulum
- Open fracture acetabulum, anterior column
- Open fracture of anterior column and posterior column of acetabulum
- Open fracture of anterior column and posterior column of left acetabulum
- Open fracture of anterior column of left acetabulum
- Open fracture of left acetabulum
- Open fracture of posterior column of left acetabulum
Coding GuidelinesGuidance
The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site, to the level of detail furnished by medical record content.
A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.
Initial vs. Subsequent Encounter for Fractures
Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) while the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.
Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N) or subsequent care with malunion (P, Q, R).
The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).
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 S32.432A: its own notes plus those printed at S32.4, S32, block S30-S39, 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.
- fracture of lumbosacral neural arch
- fracture of lumbosacral spinous process
- fracture of lumbosacral transverse process
- fracture of lumbosacral vertebra
- fracture of lumbosacral vertebral arch
- injuries to the abdominal wall
- injuries to the anus
- injuries to the buttock
- injuries to the external genitalia
- injuries to the flank
- injuries to the groin
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
Code First
The underlying condition named in the note is sequenced before this code.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- 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.
Notes
General instructions on how these codes are used.
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as opened or closed should be coded to closed
- 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.
- The appropriate 7th character is to be added to each code from category S32
- Ainitial encounter for closed fracture this code
- Binitial encounter for open fracture
- Dsubsequent encounter for fracture with routine healing
- Gsubsequent encounter for fracture with delayed healing
- Ksubsequent encounter for fracture with nonunion
- 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 S32.432A, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming S32.432A: they are not reported together with it, unless the two conditions are unrelated.
- M48.5 Collapsed vertebra, not elsewhere classifiedtraumatic fracture of vertebra (S12.-, S22.-, S32.-) names S32.-, which includes this code
- M84.3 Stress fracturetraumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S32.-, which includes this code
- M84.4 Pathological fracture, not elsewhere classifiedtraumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S32.-, which includes this code
Use Additional Code 1
These codes say to use an additional code from the note, and S32.432A is one of the codes named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Fractures
A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.
The full article covers:
- What is a fracture?
- What are the different types of fractures?
- What causes fractures?
- What are the symptoms of a fracture?
- How are fractures diagnosed?
- What are the treatments for fractures?
- Can fractures be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S32.432A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S32.432AOverview
Is S32.432A a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in S32.432A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for displaced fracture of anterior column [iliopubic] of left acetabulum, such as an emergency visit or first evaluation. In this category the CMS Tabular List defines A as "initial encounter for closed fracture".
What MS-DRG does S32.432A group to?
When displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 536, 521, 522, 535, 963, with relative weights from 0.8068 to 2.8516 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S32.432A a CC or MCC?
CMS lists S32.432A as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 467 closely related codes in its exclusion list.
Can S32.432A be reported with S38.3?
Not as a rule. The Excludes1 note at S32, which applies to S32.432A, lists "transection of abdomen (S38.3)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is S32.432A?
S32.432A (displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture) maps to CMS-HCC Category 402 (Hip Fracture/Dislocation), commonly written as HCC 402, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 170 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 S32.432A risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, S32.432A adds a risk adjustment factor of about 0.467 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.089 to 0.570 depending on the payment segment). HCC 402 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 402 category page.
