2026 ICD-10-CM Diagnosis Code S53.401DUnspecified sprain of right elbow, subsequent encounter
S53.401D is a billable ICD-10-CM diagnosis code for unspecified sprain of right elbow, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. Coders also document this condition as disorder of ligament of right elbow joint. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sprains and strains, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S53.401D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Disorder of ligament of right elbow joint
- Right elbow joint ligament sprain
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments of elbow (S53). 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 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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S53.401D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S53.401DOverview
Is S53.401D (Unspecified sprain of right elbow) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified sprain of right elbow, subsequent encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character D in S53.401D mean?
The final character D marks a subsequent encounter: use it for routine care while the unspecified sprain of right elbow is healing, after active treatment has ended.
What MS-DRG does S53.401D group to?
When unspecified sprain of right elbow, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 949, 950, with relative weights from 0.6277 to 1.1897 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S53.401D 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 unspecified sprain of right elbow, subsequent encounter on inpatient claims.
What is the ICD-9 equivalent of S53.401D?
Under the General Equivalence Mappings, unspecified sprain of right elbow, subsequent encounter converts to ICD-9-CM V58.89 (other specfied aftercare). 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.
