ICD-10 Code S62.161S: Displaced fracture of pisiform, right wrist, sequela

Key Takeaways

S62.161S is a billable ICD-10-CM code for displaced fracture of pisiform, right wrist, sequela – the parent code S62.161 is not billable on its own

The ‘S’ suffix designates a sequela encounter: use it when treating a condition that arose as a direct result of a prior pisiform fracture, not during active treatment or routine follow-up

Three billable variants exist: S62.161A (initial encounter), S62.161D (subsequent encounter), and S62.161S (sequela) – confusing D with S is the most common coding error for this code

Pabau’s insurance claims management software streamlines ICD-10 claim submission and reduces denial risk for fracture sequela encounters

Pisiform fractures are among the least common carpal injuries, but that rarity makes correct ICD-10 coding more error-prone, not less. When a patient returns months after the original fracture with chronic wrist pain, grip weakness, or flexor carpi ulnaris irritation, the coding choice shifts from active treatment to sequela – and that shift has real billing consequences. ICD-10 diagnostic code reference articles like this one exist precisely because coders need a precise, encounter-specific answer fast. This guide covers ICD-10 Code S62.161S in full: its billable status, how each 7th character variant applies, the sequela vs subsequent encounter distinction, related sibling codes, and the documentation that supports it.

This reference covers the 2026 ICD-10-CM code set. S62.161S is valid for claims submitted under the current fiscal year.

ICD-10 Code S62.161S: code details at a glance

S62.161S is a billable ICD-10-CM diagnosis code. Its full official description is Displaced fracture of pisiform, right wrist, sequela. The code is valid for the 2026 fiscal year and may be used on claims submitted to Medicare, Medicaid, and commercial payers for HIPAA-covered transactions.

For code lookup, the CDC/NCHS ICD-10-CM web tool provides official, year-specific code verification directly from the tabular list.

What S62.161S means: breaking down the code

Each segment of S62.161S carries a specific coding axis. Reading the code from left to right tells you the body region, fracture category, specific bone, laterality, and encounter type.

• S62 – Fracture of wrist and hand (the parent code block for all hand and wrist fractures)
• .1 – Fracture of other and unspecified carpal bone(s), specifically within the pisiform subgroup
• .16 – Displaced fracture of pisiform (displacement is explicitly documented; this distinguishes it from nondisplaced)
• 1 – Right wrist (laterality; “2” would indicate left, “9” unspecified)
• S – Sequela encounter (7th character; the patient is being treated for a condition caused by the prior fracture)

The displacement qualifier matters for both clinical and coding accuracy. Displaced fractures involve bone fragment movement out of anatomical alignment, which affects treatment decisions and, consequently, code selection. Documenting displacement status in the clinical note is what separates a billable S62.161S from an unspecified or incorrectly coded claim.

The pisiform bone: anatomy and clinical relevance

The pisiform is the smallest of the eight carpal bones. It sits in the proximal row of the wrist, on the ulnar (little finger) side, embedded within the tendon of the flexor carpi ulnaris. Because it functions as a sesamoid bone, it transmits force rather than bearing direct axial load.

Fractures occur most often from a fall on an outstretched hand, a direct blow to the ulnar wrist, or repetitive stress in sport. Athletes in racket sports, golf, and baseball are disproportionately affected. This is where sports medicine clinic software often captures these diagnoses in structured records, supporting accurate coding downstream. For practices handling musculoskeletal caseloads, physical therapy practice management tools that integrate diagnosis coding help reduce documentation gaps at the point of care.

Sequelae of pisiform fractures include chronic ulnar wrist pain, grip weakness, pisotriquetral arthritis, and flexor carpi ulnaris irritation. These residual conditions are what trigger a sequela encounter – and therefore the use of ICD-10 Code S62.161S rather than the initial or subsequent encounter variants.

Understanding the 7th character: A, D, and S encounter types

ICD-10-CM requires a 7th character extension for all fracture codes in the S62 block. The parent code S62.161 is not billable without one. Three valid characters apply to displaced pisiform fractures of the right wrist.

S62.161A: initial encounter

Use S62.161A when the patient is first receiving definitive care for the acute fracture. This includes the emergency department visit, surgical reduction, or initial immobilisation. The code applies throughout the active treatment phase, even if the patient sees a different provider, as long as active treatment is ongoing.

S62.161D: subsequent encounter

S62.161D applies once active treatment has concluded and the patient returns for routine care: cast removal, physiotherapy check-ins, or wound monitoring. The fracture is still healing or recently healed, but no new active intervention is being provided.

S62.161S: sequela encounter

ICD-10 Code S62.161S applies when the patient presents with a condition that is a direct consequence of the original fracture. Healing may be complete, but the patient now has chronic ulnar wrist pain, reduced grip strength, or pisotriquetral joint degeneration attributable to the prior injury. Sequela encounters require two codes: S62.161S for the nature of the sequela, and an additional code for the specific residual condition being treated.

Sequela vs subsequent encounter: key coding distinction

This is the most common source of coding error on pisiform fracture claims. The distinction is clinical, not chronological. How much time has passed since the original injury does not determine whether to use D or S. What matters is the reason for the visit.

According to the CMS ICD-10-CM Official Guidelines for Coding and Reporting, sequela codes should be sequenced after the code identifying the nature of the sequela. The original injury code (S62.161S) is listed after the residual condition code in sequela encounters.

Displaced vs nondisplaced pisiform fracture: coding differences

Displacement status is a required coding axis for pisiform fractures. Two codes cover fractures of the pisiform, right wrist – and they are not interchangeable.

If the clinical documentation does not explicitly state whether the fracture is displaced or nondisplaced, ICD-10-CM guidelines default to displaced. However, relying on this default is a documentation risk. A payer audit that finds “displaced” coded without radiological or clinical support may trigger a denial or request for records. Documenting displacement in the assessment section of the note avoids that exposure.

Code hierarchy and classification

S62.161S sits within a well-defined ICD-10-CM hierarchy. Understanding the parent-to-child structure helps coders navigate related codes and avoid common look-alike errors.

Related ICD-10 codes for wrist and carpal fractures

Coders working with wrist fracture claims regularly cross-reference these sibling and parent codes. The AAPC Codify ICD-10-CM lookup provides a searchable interface for the full S62 range. For ICD-10 diagnosis codes for related conditions in the upper extremity, see also Pabau’s ICD-10 diagnosis codes for related conditions reference series.

Documentation requirements for S62.161S

Supporting documentation for a sequela encounter must establish a direct causal link between the original pisiform fracture and the current condition being treated. Payers reviewing ICD-10 Code S62.161S claims look for specific elements. When medical billing workflows are not aligned with documentation standards, sequela claims are among the first flagged for additional review.

• Prior injury history: The note should reference the original fracture, ideally with date of injury or treating facility
• Causal relationship: The assessment must explicitly state that the current condition (chronic pain, arthritis, weakness) results from the prior fracture
• Residual condition code: A separate code for the specific sequela being treated must accompany S62.161S
• Displacement documentation: The original imaging or operative note (or a reference to it) confirming displaced fracture
• Laterality confirmation: Right wrist must be consistently documented across the chart; conflicting laterality triggers payer queries

For practices managing ICD-10 coding for injury-related diagnoses across multiple providers, structured documentation at the point of care reduces downstream claim errors. Pabau’s insurance claims management supports structured diagnosis entry aligned with ICD-10-CM requirements, helping coding teams submit cleaner claims via Pabau’s Claim.MD clearinghouse integration, which connects to over 4,000 US payers for real-time eligibility and electronic claim submission.

ICD-10-CM official coding guidelines for fracture sequela

The ICD-10-CM Official Guidelines for Coding and Reporting, maintained jointly by CMS (Centers for Medicare and Medicaid Services) and the NCHS (National Center for Health Statistics), govern how sequela codes are applied. Key rules for fracture sequela encounters include:

• The sequela code (S62.161S) is sequenced after the code for the nature of the sequela (the residual condition)
• The 7th character S applies only when the fracture itself has healed and the patient is now presenting with a condition resulting from that injury
• Active fracture care and sequela coding are mutually exclusive for the same encounter
• There is no time minimum or maximum for using the S character; what matters is the clinical state, not the calendar

The American Health Information Management Association (AHIMA) and the AHA Coding Clinic for ICD-10-CM/PCS provide supplementary guidance on fracture encounter type selection. Coders should consult the ICD List free lookup tool for quick code verification and hierarchy navigation. Staying aligned with medical billing compliance guidelines also helps practices avoid audit exposure when sequela coding patterns deviate from expected claim ratios.

Common coding errors to avoid with ICD-10 Code S62.161S

This is where most coding teams lose claims on displaced pisiform fractures. The errors below are drawn from common coder confusion patterns reported in AAPC and AHIMA community forums – gaps that competing reference pages rarely address in one place. Understanding ICD-10 coding for injury-related diagnoses more broadly helps coders recognize these patterns across injury categories.

• Using D instead of S for late-presenting conditions: A patient returning 18 months post-fracture with pisotriquetral arthritis is a sequela encounter (S), not a subsequent encounter (D). The time elapsed is irrelevant; the reason for the visit drives the choice.
• Submitting the parent code S62.161 without a 7th character: This code is explicitly non-billable. Claims submitted with the 6-character parent will be rejected. Always append A, D, or S.
• Omitting the residual condition code: S62.161S should not stand alone on a sequela claim. A second code identifying what is being treated (e.g., M25.831 for pain in right wrist) is required per ICD-10-CM guidelines.
• Conflating displacement status: Coding S62.161S (displaced) when the original injury was nondisplaced – or when displacement was never documented – creates clinical inconsistency that auditors flag.
• Missing laterality: Right wrist (S62.161S) and left wrist (S62.162x) are distinct codes. Chart-wide consistency on laterality prevents payer queries and claim delays.

Practices with structured denial management in medical billing processes catch these errors before submission. An occupational therapy practice software platform that enforces structured ICD-10 entry reduces the chance of a coder appending the wrong 7th character at the point of billing.

Reduce ICD-10 coding errors before they reach the payer

Pabau integrates with Claim.MD to support clean ICD-10 claim submission across 4,000+ US payers. See how structured diagnosis entry and real-time eligibility verification reduce denial rates for fracture and injury claims.

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Conclusion

Pisiform fracture sequela encounters are low-volume but high-error-rate coding scenarios. The difference between a clean S62.161S claim and a denial often comes down to three things: applying the correct 7th character, pairing the sequela code with a residual condition code, and documenting the causal link explicitly in the clinical note.

Pabau’s revenue cycle management tools, integrated with Claim.MD, support structured ICD-10 entry and real-time claim validation so these errors surface before submission rather than after a denial. To see how it works in practice, book a demo with the Pabau team.

Continue your research

Need to understand the full claims submission workflow? Claim.MD clearinghouse overview covers how electronic claim submission and payer connectivity work for US practices.

Managing denials on injury-related claims? Denial codes in medical billing explains common CARC denial reason codes and how to respond to them.

Want to understand clean claim requirements? Clean claim standards outlines the documentation and coding requirements that prevent rejections before they happen.

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