ICD-10 code S52.022E: Displaced left olecranon fracture

Key takeaways

ICD-10 code S52.022E covers a displaced fracture of the olecranon process of the left ulna, without intraarticular extension. The 7th character E marks a subsequent encounter for an open type I or II fracture with routine healing.

The sixth digit carries laterality. S52.021 is the right ulna, S52.022 is the left ulna, and S52.023 is used when the side is not documented.

S52.022E is billable and valid for FY2026 HIPAA-covered transactions. The base code S52.022 is not billable without a 7th character.

The 7th character E needs explicit physician documentation of an open Gustilo type I or II fracture. The note must also confirm routine healing, not delayed healing or nonunion.

Practice management software like Pabau helps orthopedic practices structure fracture encounter records, so laterality and healing status are captured at the point of care.

ICD-10 code S52.022E is a billable code for a displaced fracture of the olecranon process of the left ulna, without intraarticular extension. The 7th character E marks a subsequent encounter for an open type I or II fracture with routine healing.

Two details decide the code. The sixth digit is what makes S52.022x left-sided. The 7th character has to match both the fracture type and the healing status in the note.

Coders usually capture the site and displacement correctly, then default to the unspecified-side code or the wrong encounter character.

The Centers for Medicare and Medicaid Services, known as CMS, updates ICD-10-CM every fiscal year. Every character has to be backed by provider documentation, and this reference maps each part of S52.022E to the documentation that supports it.

Coders in orthopedic and physical therapy practices meet olecranon fracture codes at almost every post-operative follow-up. Getting S52.022E right comes down to six documentation elements the treating physician has to provide.

ICD-10 code S52.022E: Full description and billability

ICD-10 code S52.022E is a billable, specific diagnosis code valid for FY2026 HIPAA-covered transactions. It carries the following complete official description:

Displaced fracture of olecranon process without intraarticular extension of left ulna, subsequent encounter for open fracture type I or II with routine healing.

• Laterality: Left ulna. The sixth digit fixes the side, so S52.022x is never the right or the unspecified side.
• Billable: Yes. S52.022E is a specific, complete code accepted for claim submission.
• FY2026 status: Valid and active under the current ICD-10-CM annual update cycle.
• HIPAA transaction coverage: Accepted for all covered electronic healthcare transactions.
• Parent code S52.022 alone: Not billable. The 7th character is mandatory for any S52.022x code to be submitted on a claim.

You can confirm current code validity before submission with the CDC/NCHS ICD-10-CM web tool. It mirrors the official tabular list and index, updated each fiscal year.

ICD-10-CM code hierarchy for S52.022E

S52.022E sits within the S52 category covering fractures of the forearm. Each level of the hierarchy contributes one piece of the final code’s meaning. The fifth digit carries displacement and articular status, and the sixth digit carries laterality. The seventh carries encounter type and healing status.

That is why a coder cannot stop at S52.022 and has to append the 7th character. Neighboring forearm codes are built the same way, as S52.001E shows on the radius.

Understanding the 7th character ‘E’ in S52.022E

The 7th character is not optional for S52.022x codes. It encodes three clinical facts at once:

• Whether the fracture was open or closed.
• Whether this is the initial encounter or a subsequent one.
• Whether healing is routine, delayed, nonunion, or malunion.

Character E combines all three in one position. It means a subsequent encounter for an open type I or II fracture that is healing routinely.

All valid 7th characters for S52.022 are listed below. Choosing between D and E means checking whether the fracture was open. Choosing between E, F, H, and J means checking the Gustilo grade in the operative note.

What ‘subsequent encounter’ means in fracture coding

Subsequent encounter, characters D through R, applies to every visit after the patient has received definitive treatment. That includes post-operative check-ups, cast changes, wound checks, and physical therapy visits where the fracture is still the primary diagnosis. Initial encounter, characters A through C, applies only to the visit where active treatment is given.

The same convention runs across body sites. S02.600D covers a mandible fracture at a follow-up visit with routine healing. S42.90XG is the shoulder girdle equivalent with delayed healing.

Sequela, character S, is different from subsequent. It applies once active healing is complete and a residual condition remains from the fracture. Coding S52.022S while the fracture is still under active care is a common error with audit implications.

Open fracture type I or II: The Gustilo-Anderson classification

The 7th character E requires the fracture to have been classified as Gustilo-Anderson type I or II at the time of surgical treatment. Only the treating surgeon can assign Gustilo type, based on intraoperative findings.

• Type I: Wound under 1 cm, minimal contamination, simple fracture pattern, adequate soft tissue coverage.
• Type II: Wound 1-10 cm, moderate contamination, moderate soft tissue injury, adequate coverage achievable.
• Types IIIA, IIIB, and IIIC: These route to 7th characters C, F, J, N, or R instead, depending on encounter type and healing status.

Coders cannot infer Gustilo type from the mechanism of injury or the wound description alone. The operative note has to state the classification explicitly. That requirement comes from ICD-10-CM’s own conventions. The Official Guidelines for Coding and Reporting, along with Coding Clinic advice from the American Hospital Association, put the classification in the provider’s hands.

The 7th character structure is specific to ICD-10-CM, the US adaptation maintained by CDC and NCHS. The international ICD-10 published by WHO does not use it.

Clinical anatomy: Displaced left olecranon fracture without intraarticular extension

The olecranon is the posterior bony prominence of the elbow, forming the proximal end of the ulna. It serves as the insertion point for the triceps tendon. Only a thin layer of soft tissue covers it, which leaves it exposed to direct trauma.

Olecranon fractures typically follow a fall on an outstretched hand, a direct blow to the elbow, or high-energy trauma. They account for roughly 10% of upper extremity fractures treated in emergency settings, according to orthopedic literature.

• Left ulna: The injury is on the left side. The right-side equivalent is S52.021x, and S52.023x is reserved for records that never state a side.
• Displaced: Fracture fragments have separated by 2 mm or more from their anatomical position. On the left ulna, the nondisplaced equivalent is S52.025x.
• Without intraarticular extension: The fracture line does not extend into the ulnohumeral joint space. A displaced left olecranon fracture that does reach the joint is coded S52.032x instead. That distinction changes surgical planning and prognosis.
• Open fracture: The fracture communicates with the external environment through a skin wound, documented intraoperatively.

From a coding perspective, laterality, displacement status, and intraarticular involvement are three separate documentation requirements. All three must be stated explicitly in the treating physician’s note before a coder can select S52.022E over an adjacent code.

Documentation requirements for accurate S52.022E coding

S52.022E requires six distinct documentation elements, and each one corresponds to a component of the code. Miss one and the code shifts to a less specific or an outright incorrect alternative. The table below maps each element to the documentation problem coders hit most often.

Practices using digital forms can build orthopedic encounter templates that prompt for all six elements at the point of care. That removes most of the queries a coder would otherwise send back to the physician days later.

Related ICD-10-CM codes for olecranon and ulna fractures

Selecting S52.022E correctly means separating it from sibling codes that differ by laterality, displacement status, articular involvement, or encounter type. The first two rows below are the codes most often confused with S52.022E. Both describe the same fracture, on the right side or on a side that was never documented.

Practices managing sports medicine or orthopedic caseloads will see all of these codes across a single episode of care. The intraarticular siblings follow the same 7th character pattern, as S52.033J does with delayed healing. The AAPC code lookup is a searchable way to verify adjacent codes.

Coding tips: avoiding common errors with S52.022E

Documentation requirements only become useful once you can name the error each missing element produces. The patterns below account for most rejected and re-coded S52.022x claims. Physical therapists treating these patients through rehabilitation file subsequent encounter claims alongside the surgeon’s follow-up visits.

• Error 1: Treating S52.022 as the laterality-unspecified code. S52.022 is specific to the left ulna. The right side is S52.021 and the unspecified side is S52.023. Coding S52.022E for a right olecranon fracture puts the wrong side on the claim.
• Error 2: Defaulting to S52.023x when the side is documented. The unspecified-side code belongs on a claim only when nothing in the record states a side. Reach for the radiology report or the operative note first, since one of them almost always names the elbow.
• Error 3: Using parent code S52.022 alone. S52.022 without a 7th character is not billable, and claims submitted with it will reject. Always append a 7th character.
• Error 4: Selecting D instead of E for open fractures. Character D applies to subsequent encounters for closed fractures only. If the original fracture was open, the subsequent encounter takes E, H, M, or Q depending on Gustilo type and healing status.
• Error 5: Coding E without a documented Gustilo type. If the operative note says “open fracture” but gives no Gustilo type, query the surgeon first. Selecting E over F, H, or J without that documentation creates a claim with unsupported specificity.
• Error 6: Confusing subsequent encounter with sequela. The 7th character S applies only once the fracture has healed and a residual late effect is being treated. Using S during active post-operative follow-up is wrong both clinically and technically.
• Error 7: Coding S52.022E when articular extension is undocumented. If neither the operative nor the radiology report states whether the fracture reaches the joint, you cannot choose between S52.022x and S52.032x. Query the physician instead of defaulting.

Structuring patient records with templated fracture encounter fields removes most of these errors at the point of care. Free text is where most of them start. Clinical documentation software that captures displacement, Gustilo type, and healing status in structured fields cuts coder queries.

Approximate synonyms and clinical terminology

The following terms turn up in operative reports, clinical notes, and radiology reports. Each maps to ICD-10 code S52.022E once all six documentation elements are confirmed.

Knowing the variants helps a coder recognize the right code inside free-text clinical language. Every one of them names the left side, because a phrase without a side cannot support S52.022E.

• Displaced left olecranon fracture, open, type I/II, subsequent follow-up
• Open displaced fracture of the left proximal ulna without joint involvement, follow-up visit
• Displaced fracture of left elbow (olecranon), extraarticular, open wound, post-operative check
• Left olecranon process fracture, displaced, no intraarticular extension, Gustilo I/II, healing normally
• Open left elbow fracture (olecranon), subsequent encounter, routine course

None of these phrases confirms S52.022E on its own. Each has to be checked against all six documentation requirements described above. One principle governs the choice. Code to the highest level of specificity the documentation supports, not the highest level a coder can infer.

How Pabau supports olecranon fracture coding and documentation

In most orthopedic practices the six elements behind S52.022E live in free text. The side sits in a radiology header, and the Gustilo grade sits mid-paragraph in the operative note. Healing status is often implied rather than stated.

A coder reads all of it after the visit, then sends a query when something is missing. That round trip is where the delay in accounts receivable starts.

Practice management software like Pabau takes a different route. You build the fracture follow-up template once, and each of the six elements gets its own structured field. The provider completes them during the encounter, and claims management carries the same values through to the claim.

The outcome is a shorter loop between the visit and a clean claim. Documentation problems surface while the patient is still in the room, not in a denial letter weeks later.

Reduce fracture coding denials with structured documentation

Pabau helps orthopedic and musculoskeletal practices configure encounter templates that capture all six S52.022E documentation elements at the point of care. Missing elements get fixed before claims reach the clearinghouse.

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Conclusion

Two habits keep S52.022E claims clean. Read the side off the record instead of assuming it. Then confirm the Gustilo grade before you choose between D and E as the 7th character. Everything else in this code follows from what the surgeon wrote down.

If the note cannot support that specificity, query the physician rather than reaching for the unspecified-side code. A query costs a day. A miscoded side can cost the claim, and it leaves the wrong clinical picture in the patient’s record.

Structured fields at the point of care are what make that habit easy to keep. Book a demo to see how Pabau captures laterality, Gustilo grade, and healing status while the patient is still in the room.

Continue your research

Coding a radius fracture next? S52.131R covers a displaced fracture of the neck of the right radius, with the same 7th character logic.

Billing anesthesia for a nonunion repair? CPT code 01744 covers anesthesia for elbow nonunion and malunion procedures.

Documenting a bone graft during revision surgery? CPT code 20902 sets out the billing rules for a major or large bone graft.

Assessing elbow instability in rehabilitation? Lateral pivot shift test explains how to perform, grade, and interpret the result.

Ruling out a biceps tear at follow-up? Bicep tear test compares the hook test with Yergason’s and says when to use each.

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