2027 ICD-10-CM Diagnosis Code S48.121SPartial traumatic amputation at level between right shoulder and elbow, sequela
ICD-10-CM Codes›S00–T88›S40-S49›S48
- Billable — Valid for Submission
- POA Exempt
- 7th Character S — Sequela
- Chronic Condition
S48.121S is a billable ICD-10-CM diagnosis code for partial traumatic amputation at level between right shoulder and elbow, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 559 through 561. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
S48.121S no longer risk-adjusts for Medicare Advantage: it mapped to HCC 189 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 189, ESRD (V21) category 189, and ESRD (V24) category 189 for payment year 2027.
Code Identity
Code Classification
Present on Admission (POA)Billing
S48.121S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the shoulder and upper arm (S40-S49).
Medicare Risk Adjustment (HCC)Billing
S48.121S no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
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.
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Traumatic amputation of shoulder and upper arm (S48). 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 S48.121S: its own notes plus those printed at S48, block S40-S49, 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.
- injuries of axilla
- injuries of scapular region
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.
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.-)
Notes
General instructions on how these codes are used.
- 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 S48
- Ainitial encounter
- Dsubsequent encounter
- Ssequela this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S48.121S, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming S48.121S: they are not reported together with it, unless the two conditions are unrelated.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Limb Loss
People can lose all or part of an arm or leg for many reasons. Common ones include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S48.121S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S48.121SOverview
Is S48.121S a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report partial traumatic amputation at level between right shoulder and elbow, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character S in S48.121S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the partial traumatic amputation at level between right shoulder and elbow itself has resolved, not the original event.
What MS-DRG does S48.121S group to?
When partial traumatic amputation at level between right shoulder and elbow, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 561, 560, with relative weights from 0.8258 to 1.8087 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S48.121S exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for partial traumatic amputation at level between right shoulder and elbow, sequela on inpatient claims. The code appears in the Injuries to the shoulder and upper arm (S40-S49) range of the CMS exempt list.
Can S48.121S be reported with S58.0?
Not as a rule. The Excludes1 note at S48, which applies to S48.121S, lists "traumatic amputation at elbow level (S58.0)". 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).
Does S48.121S risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. S48.121S mapped to HCC 189 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 189 (Amputation Status/Lower Limb/Amputation Complications), ESRD (V21) category 189 (Amputation Status/Lower Limb/Amputation Complications), and ESRD (V24) category 189 (Amputation Status/Lower Limb/Amputation Complications).
