2024 ICD-10-CM Diagnosis Code S34.3XXD
Injury of cauda equina, subsequent encounter
- ICD-10-CM Code:
- S34.3XXD
- ICD-10 Code for:
- Injury of cauda equina, subsequent encounter
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Chronic
- Code Navigator:
S34.3XXD is a billable diagnosis code used to specify a medical diagnosis of injury of cauda equina, subsequent encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S34.3XXD is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like injury of cauda equina. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Cauda equina injury without spinal bone injury
- Closed fracture of sacrum AND/OR coccyx with cauda equina injury
- Closed fracture of sacrum AND/OR coccyx with complete cauda equina lesion
- Closed fracture of sacrum with complete cauda equina lesion
- Closed fracture sacrum
- Closed injury cauda equina
- Closed spinal dislocation with cauda equina lesion
- Closed spinal dislocation with cauda equina lesion
- Closed spinal fracture with cauda equina lesion
- Closed spinal fracture with cauda equina lesion
- Closed spinal fracture with cauda equina lesion
- Closed spinal fracture with cauda equina lesion
- Closed spinal subluxation with cauda equina lesion
- Closed subluxation lumbar spine
- Injury of cauda equina
- Open fracture of sacrum AND/OR coccyx with cauda equina injury
- Open fracture of sacrum AND/OR coccyx with complete cauda equina lesion
- Open fracture of sacrum with complete cauda equina lesion
- Open fracture sacrum
- Open injury cauda equina
- Open spinal dislocation with cauda equina lesion
- Open spinal dislocation with cauda equina lesion
- Open spinal fracture with cauda equina lesion
- Open spinal fracture with cauda equina lesion
- Open spinal fracture with cauda equina lesion
- Open spinal fracture with cauda equina lesion
- Open spinal subluxation with cauda equina lesion
- Spinal subluxation with cauda equina lesion
- Spinal subluxation with cauda equina lesion
Clinical Classification
Clinical Category is Spinal cord injury (SCI), subsequent encounter
- CCSR Category Code: INJ046
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Coding Guidelines
The appropriate 7th character is to be added to each code from block Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level (S34). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Present on Admission (POA)
S34.3XXD is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert S34.3XXD to ICD-9-CM
- ICD-9-CM Code: V58.89 - Other specfied aftercare
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.