2027 ICD-10-CM Diagnosis Code S52.254RNondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

ICD-10-CM Codes›S00–T88›S50-S59›S52

ICD-10-CM S52.254R
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S52.254R is a billable ICD-10-CM diagnosis code for nondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion. The 7th character R means subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 564 through 566. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 5,561 closely related codes. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of the upper limb, subsequent encounter.

Code Identity

ICD-10-CM Code
S52.254R
Billable Status
Yes — Valid for Submission
Code Describes
Nondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
Short Description
Nondisp commnt fx shaft of ulna, r arm, 7thR
Parent Code
S52.254
Nondisplaced comminuted fracture of shaft of ulna, right arm

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS50-S59Injuries to the elbow and forearm
CategoryS52Fracture of forearm
This CodeS52.254RNondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

Present on Admission (POA)Billing

S52.254R is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the elbow and forearm (S50-S59).

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 S52.254R: its own notes plus those printed at S52, block S50-S59, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From S52 Fracture of forearm applies to 2,796 codes
  • traumatic amputation of forearm (S58.-)

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 S52 Fracture of forearm applies to 2,796 codes
  • fracture at wrist and hand level (S62.-)
  • periprosthetic fracture around internal prosthetic elbow joint (M97.4)
From Block S50-S59 Injuries to the elbow and forearm applies to 4,362 codes
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of wrist and hand (S60-S69)
  • 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.-)

Notes

General instructions on how these codes are used.

From S52 Fracture of forearm applies to 2,796 codes
  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed
  • The open fracture designations are based on the Gustilo open fracture classification
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 S52 Fracture of forearm applies to 2,796 codes
  • The appropriate 7th character is to be added to all codes from category S52
Values for category S52 Open Fracture Type Encounter
  • Ainitial encounter for closed fracture
  • Binitial encounter for open fracture type I or II
  • Cinitial encounter for open fracture type IIIA, IIIB, or IIIC
  • Dsubsequent encounter for closed fracture with routine healing
  • Esubsequent encounter for open fracture type I or II with routine healing
  • Fsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
  • Gsubsequent encounter for closed fracture with delayed healing
  • Hsubsequent encounter for open fracture type I or II with delayed healing
  • Jsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
  • Ksubsequent encounter for closed fracture with nonunion
  • Msubsequent encounter for open fracture type I or II with nonunion
  • Nsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
  • Psubsequent encounter for closed fracture with malunion
  • Qsubsequent encounter for open fracture type I or II with malunion
  • Rsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion this code
  • 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 S52.254R, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming S52.254R: they are not reported together with it, unless the two conditions are unrelated.

  • M84.3 Stress fracture
    traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S52.-, which includes this code
  • M84.4 Pathological fracture, not elsewhere classified
    traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S52.-, which includes this code
  • S51 Open wound of elbow and forearm
    open fracture of elbow and forearm (S52.- with open fracture 7th character) names S52.-, which includes this code

Excludes2 2

These codes carry an Excludes2 note naming S52.254R: its condition is not part of those codes, and both may be reported when the patient has both.

  • S52.0 Fracture of upper end of ulna
    fractures of shaft of ulna (S52.2-) names S52.2-, which includes this code
  • S62 Fracture at wrist and hand level
    fracture of distal parts of ulna and radius (S52.-) names S52.-, which includes this code

Clinical ClassificationClinical

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

CCSR INJ041
Fracture of the upper limb, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Read the full article at MedlinePlus

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

Convert S52.254R to ICD-9-CMHistory

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

ICD-9-CM
733.81 Malunion of fracture
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 S52.254ROverview

Is S52.254R (Nondisplaced comminuted fracture of shaft of ulna, right arm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report nondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character R in S52.254R mean?

The final character R means subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion, in this case for the nondisplaced comminuted fracture of shaft of ulna, right arm. It comes from the 7th character list in the CMS Tabular List for this category.

What MS-DRG does S52.254R group to?

When nondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 564, 566, 565, with relative weights from 0.7374 to 1.4909 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S52.254R a CC or MCC?

CMS lists S52.254R as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 5,561 closely related codes in its exclusion list.

Is S52.254R 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 nondisplaced comminuted fracture of shaft of ulna, right arm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion on inpatient claims. The code appears in the Injuries to the elbow and forearm (S50-S59) range of the CMS exempt list.