ICD-10 code S62.011A: Displaced scaphoid fracture of the right wrist

Key takeaways

ICD-10 code S62.011A covers a displaced fracture of the distal pole of the right scaphoid, at an initial encounter for a closed fracture.

The code is billable and valid for the FY 2026 ICD-10-CM edition, which took effect on October 1, 2025.

Laterality drives most of the errors. S62.012A is the left wrist and S62.013A is an unspecified wrist, so neither substitutes for S62.011A.

The 7th character A means the patient is still in active treatment. Move to D once the visit is only about monitoring healing.

Practice management software like Pabau lets your team assign the code inside the patient record, so nobody retypes it onto the claim.

ICD-10 code S62.011A is a billable diagnosis code for a displaced fracture of the distal pole of the right scaphoid. It applies at an initial encounter for a closed fracture, and it is valid for the FY 2026 ICD-10-CM edition.

This reference covers the code breakdown, every 7th character variant, the sibling codes, documentation requirements, and the CPT codes usually paired with it.

Two details decide whether the claim clears. The record has to name the right wrist, and the 7th character has to match where the patient sits in treatment. Coders who reach for the unspecified-wrist code, or who leave the 7th character on A too long, invite payer review.

Scaphoid fractures are among the most commonly missed injuries in emergency departments. The distal pole variant covered by this code has a better blood supply than a proximal third fracture, so it usually heals well. Displacement and laterality still decide the treatment pathway and the code.

ICD-10 code S62.011A: Definition and quick reference

The CDC ICD-10-CM tool gives the full official description as follows. Displaced fracture of distal pole of navicular [scaphoid] bone of right wrist, initial encounter for closed fracture.

The FY 2026 edition took effect on October 1, 2025 and runs through September 30, 2026.

Clinical meaning: A displaced break at the distal pole

Every word in the code description carries coding weight. A positive scaphoid fracture test sends the patient to imaging, and the imaging report supplies the region and displacement status the code needs.

• Displaced fracture: The fragments have moved out of normal anatomical alignment. Per ICD-10-CM Official Guidelines Section I.C.19.c, a fracture not documented as displaced or nondisplaced is coded as displaced. Nondisplaced distal pole fractures use S62.014 through S62.016 instead.
• Distal pole: The scaphoid has three regions. They are the proximal third, the middle third or waist, and the distal pole. The distal pole has a relatively robust blood supply, which shapes both healing prognosis and treatment choice.
• Navicular [scaphoid] bone: Navicular and scaphoid are synonyms in ICD-10-CM. The code description uses both, so either term in the record supports the code.
• Right wrist: Laterality is built into the 6th character. The same fracture on the left maps to S62.012A, and a record that never names a side falls to S62.013A.
• Initial encounter for closed fracture: The 7th character A signals two things at once. The patient is in the active treatment phase, and the skin over the fracture site is intact.

Code breakdown: What each character means

ICD-10-CM uses a hierarchical seven-character structure. Each position in S62.011A encodes a specific clinical detail. Knowing the structure helps coders catch errors before submission. It also speeds up lookups across the S62 block, which covers fractures at the wrist and hand level.

The 6th character is where most errors start, because it carries displacement status and laterality together. A single digit separates a right-wrist displaced fracture from a left-wrist or unspecified-wrist one.

7th character options: Closed, open, and encounter type

The S62.011 stem supports seven valid 7th characters, and the same set runs across the whole S62 category. A sequela code such as S62.232S sits at the far end of that range.

Picking the wrong character is the most frequent error on scaphoid fracture claims. A runs for the entire active treatment period, not just the first calendar visit.

S62.011A vs related scaphoid fracture codes

The S62.01 subcategory covers fractures of the distal pole of the navicular (scaphoid) bone. Inside it, the 6th character encodes displacement status and laterality at the same time.

Hand fracture codes such as S62.351P pack the same pair of details into one digit. The table below shows the full subcategory at the initial closed-fracture encounter.

Fractures elsewhere in the scaphoid sit outside this subcategory. Middle third fractures belong to S62.02, and proximal third fractures to S62.03. If the record names the scaphoid but not the region, S62.00 applies. Confirm displacement from the radiology report rather than assuming it.

When the code applies: Clinical scenarios at an initial encounter

Emergency departments and orthopedic offices are the most common settings for S62.011A. Scaphoid fractures usually follow a fall on an outstretched hand. Clinicians in sports medicine practices and emergency settings see that mechanism constantly. The code applies when all of the following are true at the encounter.

• The patient is presenting for active treatment, not monitoring of a fracture that has already been managed.
• Imaging by X-ray, CT, or MRI confirms a fracture at the distal pole of the scaphoid.
• The fracture is displaced, or displacement is not documented, in which case the guidelines default to displaced.
• The affected side is the right wrist, and the record says so.
• The fracture is closed, with skin intact. If the skin is broken at the injury site, S62.011B applies instead.

Common mistake: using S62.011A for a routine four-week orthopedic follow-up on a fracture that is healing normally. S62.011D is the right code there.

The active treatment phase ends when the provider shifts from managing the fracture to monitoring it. Once immobilization ends, care often moves to physical therapy for grip strength and range of motion.

Documentation requirements for correct code assignment

Claim reviewers look for specific documentation elements when they process codes in the S62 block. Missing any one of them creates denial risk. Practices using digital intake forms can build prompts for laterality and fracture classification into the orthopedic intake workflow. That catches problems before the coder ever sees the chart.

• Fracture type: The record must say displaced, or carry the radiologist’s reading if displacement is unclear. Fracture of scaphoid on its own does not support this code.
• Anatomical location: Distal pole or distal third must appear. A scaphoid fracture without a named region cannot support S62.011.
• Bone identification: Navicular and scaphoid are both acceptable. Wrist fracture alone does not suffice.
• Laterality: Right or left must be documented explicitly. Records that omit the side fall to S62.013A, and unspecified codes carry higher denial rates.
• Fracture classification: Open or closed must be determinable. Where wound status is undocumented, ICD-10-CM defaults to closed.
• Encounter type: The clinician’s note must show active management rather than surveillance of a healing fracture.
• Imaging report: A radiology report confirming fracture location and characteristics supports the assignment.

A structured clinical documentation workflow that prompts for each element at the point of care reduces the back-end burden on coding staff. It also prevents denials that never needed to happen.

ICD-10-CM fracture rules that decide the code

The CMS ICD-10-CM guidelines set the default rules that govern this code and every other trauma code in the S chapter. Those defaults protect coders when documentation is thin, but they only run in one direction.

• Default to displaced: Under Section I.C.19.c, a fracture not described as displaced or nondisplaced is coded as displaced. For a documented right-wrist distal pole fracture, that lands on S62.011A.
• Default to closed: A fracture not described as open or closed is coded as closed. That puts the 7th character on A rather than B. An open-fracture code such as S32.492B needs the wound documented at the site.
• Laterality has no default: Unspecified-wrist codes do exist for this fracture pattern. S62.013A covers the displaced version and S62.016A the nondisplaced one. Both are billable, but they invite payer review, so document the side.
• Sequencing with external cause codes: S62.011A is sequenced as the principal or first-listed code. External cause codes always follow it, never precede it. Use Y92 for place of occurrence, Y93 for activity, and Y99 for external cause status, plus the W code for the mechanism.
• 7th character selection is encounter-based: The 7th character reflects what is happening at the visit, not how many times the patient has been seen. Every visit during active treatment uses A.

The AAPC Codify lookup cross-references these guidelines against each code record. That extra context helps when a trauma chart carries several injuries at once.

Associated CPT codes for displaced scaphoid fracture treatment

S62.011A is a diagnosis code. What the provider does about the fracture decides which CPT procedure codes join it on the claim. Practices running orthopedic billing through dedicated claims management software reduce the risk of mismatched diagnosis and procedure pairings. The CPT code must reflect the work performed at that encounter.

Watch the anatomy: 25600 and 25605 describe closed treatment of a distal radius fracture, which is a different bone. They do not belong on a claim carrying S62.011A unless the patient also fractured the distal radius. Verify current CPT descriptions and medical necessity rules before submission.

Reimbursement and DRG considerations

S62.011A is valid for insurance submission. Facilities billing inpatient encounters should remember that DRG assignment depends on the principal diagnosis, the procedures performed, and any comorbidities.

The WHO ICD-10 browser gives international classification context, while CMS governs US reimbursement rules. Pabau’s EHR integration connects diagnosis codes to invoices and claims in one workflow.

• Billable status: S62.011A is a full seven-character code, valid for submission in outpatient and inpatient settings alike.
• POA reporting: Check the CMS present-on-admission exempt list for the current fiscal year before you assign a POA indicator on an inpatient claim.
• DRG context: DRG assignment for upper extremity fractures varies with the principal diagnosis, comorbidities, and procedures. Run the full claim through the current CMS grouper rather than assuming a DRG.
• Payer-specific rules: Some payers require prior authorization for surgical treatment of a displaced scaphoid fracture. Check the policy before scheduling CPT 25628.

How Pabau supports scaphoid fracture coding accuracy

Coding accuracy for this fracture is decided at the point of care, well before the chart reaches the billing queue. When the note leaves out the side or the pole, the coder has to choose between a physician query and an unspecified code. Both cost the practice time and money.

Pabau is an all-in-one practice management system that keeps the clinical record and the claim in the same place. Clinicians capture the injury on structured forms and templates, and the diagnosis code is assigned against that same patient record. Imaging notes, consent, and treatment history sit alongside it.

Because the code travels with the record, it reaches the invoice and the claim without anyone retyping it. Coders spend less time chasing charts for laterality, and fewer claims come back for a detail that was captured at the visit.

Stop switching between tabs to code fractures

Pabau lets your team search, assign, and submit ICD-10 diagnosis codes like S62.011A directly inside the patient record. No copy-paste, no transcription errors, and no context-switching between your EHR and a standalone lookup tool.

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Conclusion

Precision is the whole point of this code. S62.011A fits one injury, on one side, at one stage of treatment. It only holds up when the note names the distal pole, the right wrist, and active management. Build those three prompts into your orthopedic template and the code stops being a judgment call.

The trade-off worth remembering is speed against specificity. Reaching for S62.013A closes the chart faster, but it hands the payer a reason to look twice.

Pabau keeps code assignment and claim submission inside one platform, so diagnosis codes are attached at the point of care instead of transcribed later. Book a demo to see how that works in an orthopedic or sports medicine practice.

Continue your research

Coding another initial-encounter fracture? S32.416A shows how the same 7th character works on a pelvic fracture.

Need the sequela form of a trauma code? S33.8XXS walks through documenting late effects once the injury has healed.

Moving a patient to a subsequent encounter? S01.111D covers what changes on the claim once active treatment ends.

Coding a wrist injury that is not a fracture? S63.004S handles carpal dislocation and its late effects.

Documenting orthopedic special tests? Yocum test shows how exam findings back up a musculoskeletal diagnosis code.

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