ICD-10 Code S62.232S: First Metacarpal Fracture Sequela

Key Takeaways

S62.232S is the valid ICD-10-CM code for the sequela of an other displaced fracture of the base of the first metacarpal bone, left hand

The 7th character S (sequela) applies only after fracture healing is complete, when a residual condition directly traces back to the original injury

Sequela coding requires two codes: S62.232S plus a separate code for the specific residual condition (stiffness, pain, grip weakness)

Pabau’s claims management software helps orthopaedic and hand surgery practices submit sequela encounter claims with accurate code pairing

ICD-10 Code S62.232S: first metacarpal fracture sequela, left hand

Most claim denials in late-phase fracture care come down to one wrong character. Using S62.232D (subsequent encounter) when the fracture has fully healed and the patient presents with residual stiffness or grip weakness is one of the most common sequela-coding errors in hand surgery billing. S62.232S captures a specific and distinct clinical situation: the fracture is no longer actively healing, but a direct consequence of that original injury persists.

This reference covers the full definition of ICD-10-CM Chapter 19 injury codes as they apply to S62.232S, the complete 7th character breakdown for S62.232, the two-code sequela rule, documentation requirements, related sibling codes, and a CPT crosswalk for common sequela-phase encounters.

Code definition and clinical description

S62.232S describes the sequela of an other displaced fracture of the base of the first metacarpal bone of the left hand. The first metacarpal is the thumb’s metacarpal, and its base articulates with the trapezium at the carpometacarpal (CMC) joint. Fractures at this site are clinically significant because displacement at the CMC joint can disrupt thumb mechanics.

The qualifier “other displaced” distinguishes this code from Bennett fractures (S62.21-) and Rolando fractures (S62.22-). Bennett and Rolando fractures are intra-articular fracture-dislocations of the first metacarpal base with their own code series. S62.232 applies when the fracture is displaced but does not meet the specific pattern of those two named entities.

According to the Centers for Medicare and Medicaid Services (CMS) ICD-10-CM codes page, S62.232S is a billable code valid for FY 2025 and FY 2026 encounters. It sits within the broader ICD-10-CM sequela coding framework that governs all late-effects claims under Chapter 19.

7th character breakdown for S62.232

The parent code S62.232 requires a 7th character to be billable. Each character defines the encounter type, and selecting the wrong one is the primary source of sequela claim denials. The full set for S62.232 is as follows.

The ICD-10-CM Official Guidelines for Coding and Reporting, as searchable through the CDC/NCHS ICD-10-CM tool, clarify that 7th character S is reserved for complications or conditions arising as a direct result of a prior injury, used only after the healing phase is complete. This is distinct from subsequent encounter codes (D, G, K, P), which apply while the fracture itself is still under active treatment or monitoring.

Sequela vs subsequent encounter: when to use ICD-10 Code S62.232S

The single most important distinction in this code family is between sequela (S) and subsequent encounter (D). Both appear on follow-up visits, but they describe fundamentally different clinical situations.

• Subsequent encounter (D, G, K, P): The fracture is still the active clinical problem. The patient is returning for continued treatment, monitoring of healing, or management of a fracture complication (nonunion, malunion, delayed healing).
• Sequela (S): The fracture has healed. The patient now presents with a residual condition that is a direct result of that healed fracture. The fracture is historical, not active.

Per the ICD-10-CM Official Guidelines Section I.C.19, sequela coding requires that the provider documentation clearly links the current condition to the prior injury. A note saying “post-fracture stiffness” or “residual grip weakness following left thumb metacarpal fracture” satisfies this requirement. A note that only mentions the current symptom without connecting it to the prior fracture does not.

Common residual conditions following first metacarpal base fractures that may justify S62.232S include post-traumatic CMC joint stiffness, grip weakness, malunion-related pain at the thumb base, and reduced range of motion affecting pinch function. These are the sequelae that coders working in sports medicine and orthopaedic practices most frequently need to document and code accurately.

The two-code sequela rule for S62.232S

Per ICD-10-CM Official Guidelines Section I.C.19, sequela encounters require two codes in most cases. S62.232S alone does not fully describe the clinical picture. The correct coding sequence is:

1. Code for the sequela condition first: The specific residual condition (the reason for the visit). For example: M79.622 (pain in left hand), M62.542 (muscle wasting and atrophy, left hand), or M25.642 (stiffness of left wrist, not elsewhere classified).
2. S62.232S second: The ICD-10 code S62.232S identifies the original injury that caused the sequela condition.

The sequela code (S62.232S) is always sequenced after the code describing the manifestation. This ordering rule is specified in the WHO ICD-10 classification framework and is mirrored in the ICD-10-CM US adaptation maintained by the National Center for Health Statistics (NCHS).

Submitting S62.232S as a standalone code without a sequela manifestation code will typically result in a payer rejection or edit flag. Some payers may accept S62.232S alone on encounters where the visit purpose is clearly documented as follow-up for a prior injury, but consistent two-code sequencing reduces audit exposure. Accurate code pairing is where claims management software with built-in coding workflow support reduces errors at the point of submission.

Reduce sequela coding errors before claims leave your practice

Pabau's claims management tools help orthopaedic and hand surgery practices pair diagnosis codes accurately, reducing denials and rework on late-phase fracture encounters.

Book a demo

Sibling and related codes for ICD-10 Code S62.232S

S62.232S belongs to a family of sibling codes under S62.23 (other displaced fracture of base of first metacarpal bone). Choosing the correct laterality is essential, as payers treat left, right, and unspecified codes as distinct claims.

Use S62.233S (unspecified) only when documentation genuinely does not specify laterality. Most payers require laterality specificity for fracture sequela codes, and unspecified codes may be returned for additional documentation. Verify the operative or original injury records to confirm left-hand involvement before assigning S62.232S.

Within the broader S62.2 parent category, the related named fracture sequela codes are S62.211S (Bennett fracture, right) and S62.212S (Bennett fracture, left). Rolando fracture sequela codes fall under S62.221S and S62.222S. When the patient history includes a Bennett or Rolando fracture specifically, those codes take priority over S62.232S. Use an ICD-10-CM code lookup via AAPC Codify to verify parent-subcategory hierarchy before finalising code selection.

Clinical documentation requirements for S62.232S

Sequela coding carries a higher documentation burden than subsequent encounter coding. Payers and auditors expect the medical record to establish three things before S62.232S can be assigned.

• Prior fracture history: The original S62.232A or S62.232B encounter (initial fracture) must appear somewhere in the patient record. The current provider does not have to have treated the original fracture, but the history must be documented.
• Fracture healing status: A clinical note, imaging report, or provider statement confirming the fracture has healed. A radiograph showing osseous union or a provider note stating “healed fracture” satisfies this.
• Causal link to the current condition: The provider must explicitly connect the residual condition (stiffness, pain, weakness) to the prior fracture. Language such as “post-fracture stiffness of the left thumb CMC joint” or “grip weakness secondary to prior first metacarpal base fracture” meets this standard.

Establishing robust clinical documentation workflows for late-phase fracture encounters reduces audit risk and supports sequela code assignment at the point of care. Practices using digital intake forms can capture prior injury history during the intake process, which feeds directly into the provider’s encounter note and satisfies the first documentation requirement above.

For physical therapy documentation involving sequela of hand fractures, the same three-element standard applies. Physical therapists treating post-fracture stiffness or grip deficits must ensure the referring provider’s documentation includes the causal link, as PTs themselves may not independently assign an ICD-10 sequela code without physician documentation support in many payer contracts. For further reading on compliance requirements for musculoskeletal clinics, including documentation standards, see the linked Pabau resource.

CPT codes commonly paired with S62.232S

Sequela-phase encounters for first metacarpal base fractures involve a range of clinical services, from evaluation and management visits to surgical intervention for residual deformity. The associated CPT procedure codes depend on what service is rendered during the sequela encounter.

CPT code pairings must reflect the actual service rendered. E/M codes (99213, 99214) are the most common codes billed alongside S62.232S at orthopaedic or hand surgery follow-up visits. Surgical CPT codes (26565, 26615) apply only when a procedure is performed during the encounter. Verify payer-specific LCD policies via ICD List’s diagnosis code lookup before finalising claim submissions, as some commercial payers require prior authorisation for metacarpal osteotomy procedures.

For the broader ICD-10-CM code context and how S62.232S fits within injury and fracture coding hierarchies, the ICD-10-CM diagnosis code reference framework discussed across the Pabau diagnostic code series provides useful structural context.

Coding workflow summary

Applying ICD-10 Code S62.232S correctly involves a short decision sequence that coders should run through at each sequela encounter.

1. Confirm the fracture is healed (imaging or provider statement in the record).
2. Identify the specific residual condition the patient is presenting with.
3. Verify the provider note explicitly links the residual condition to the prior fracture.
4. Assign the manifestation code first (e.g. M79.622 for left hand pain).
5. Assign S62.232S second as the injury-origin code.
6. Select the CPT code matching the actual service provided.
7. Check payer-specific LCD or coverage policies for the manifestation code if billing Medicare or Medicaid.

Practices handling volume orthopaedic and hand surgery billing benefit most from structured claim-submission workflows. Pabau’s claims management software supports code-pairing validation at submission, which catches sequela encounters where the manifestation code is missing before the claim reaches the payer.

Conclusion

Sequela encounters for first metacarpal fractures are a routine part of hand surgery and orthopaedic follow-up, but they carry a distinct documentation and coding standard that subsequent encounter claims do not. S62.232S applies only after fracture healing is confirmed, requires a two-code sequence with the manifestation first, and demands explicit provider language linking the residual condition to the original injury.

Getting this right reduces claim rejections, supports audit readiness, and ensures that the clinical work done in sequela-phase encounters is accurately reflected in the billing record. If your practice needs help structuring practice management software that keeps documentation, coding, and claim submission aligned, book a demo with Pabau to see how the platform supports late-phase fracture care workflows.

Continue your research

Need physical therapy documentation support for sequela encounters? Physical therapy EMR software covers how Pabau supports post-fracture rehabilitation documentation and claim workflows.

Looking for a broader ICD-10 coding reference for hand and wrist injuries? ICD-10-CM Chapter 19 injury code guidance walks through the injury chapter structure and encounter-type rules that apply across fracture code families.

Want to understand how sequela rules apply across specialties? ICD-10-CM sequela coding framework provides context on how the S 7th character functions across different injury categories.

Frequently Asked Questions