2026 ICD-10-CM Diagnosis Code S52.001BUnspecified fracture of upper end of right ulna, initial encounter for open fracture type I or II
S52.001B is a billable ICD-10-CM diagnosis code for unspecified fracture of upper end of right ulna, initial encounter for open fracture type I or II. The 7th character B reports the initial encounter for an open fracture. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 562 through 563, 963 through 965. Coders also document this condition as closed fracture of proximal end of right ulna. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of the upper limb, initial encounter.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when S52.001B 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 six months after the fracture.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Closed fracture of proximal end of right ulna
- Closed fracture of right ulna
- Fracture of proximal end of right ulna
- Open fracture of proximal end of right ulna
- Open fracture of right elbow
- Open fracture of right ulna
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 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Elbow Injuries and Disorders
Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.
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Convert S52.001B to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S52.001BOverview
Is S52.001B (Unspecified fracture of upper end of right ulna) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified fracture of upper end of right ulna, initial encounter for open fracture type I or II on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character B in S52.001B mean?
The final character B reports the initial encounter for an open fracture, in this case involving the unspecified fracture of upper end of right ulna.
What MS-DRG does S52.001B group to?
When unspecified fracture of upper end of right ulna, initial encounter for open fracture type I or II is the principal diagnosis on an inpatient stay, it groups to MS-DRG 562, 563, 963, 964, 965, with relative weights from 0.8955 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S52.001B?
Under the General Equivalence Mappings, unspecified fracture of upper end of right ulna, initial encounter for open fracture type I or II converts to ICD-9-CM 813.14 (fx up ulna NEC/NOS-open). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
