2026 ICD-10-CM Diagnosis Code S93.511SSprain of interphalangeal joint of right great toe, sequela
S93.511S is a billable ICD-10-CM diagnosis code for sprain of interphalangeal joint of right great toe, 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 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 562 through 563. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S93.511S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments at ankle, foot and toe level (S93). 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
Sprains and Strains
A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S93.511S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S93.511SOverview
Is S93.511S (Sprain of interphalangeal joint of right great toe) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sprain of interphalangeal joint of right great toe, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S93.511S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the sprain of interphalangeal joint of right great toe itself has resolved, not the original event.
What MS-DRG does S93.511S group to?
When sprain of interphalangeal joint of right great toe, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 562, 563, with relative weights from 0.8955 to 1.4248 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S93.511S 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 sprain of interphalangeal joint of right great toe, sequela on inpatient claims.
What is the ICD-9 equivalent of S93.511S?
Under the General Equivalence Mappings, sprain of interphalangeal joint of right great toe, sequela converts to ICD-9-CM 905.7 (late effec sprain/strain). 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.
