ICD-10 code S62.291G: First metacarpal, delayed healing

Key takeaways

S62.291G is a billable ICD-10-CM code for other fracture of the first metacarpal bone, right hand, at a subsequent encounter with delayed healing.

The seventh character G means healing is slower than expected, which separates it from D for routine healing and K for nonunion.

Other fracture is a residual category, so Bennett, Rolando, base, shaft and neck fractures of the thumb metacarpal all code elsewhere.

Delayed healing is the provider’s documented judgment, so query the chart before you swap D for G.

Practice management software like Pabau sends CMS-1500 and 837P claims through a clearinghouse, so format errors surface early.

ICD-10 code S62.291G covers a right-hand first metacarpal fracture that is healing more slowly than it should. It is billable, and the seventh character G is the part doing that work. The rest of the code is fixed: right hand, first metacarpal, other fracture, follow-up visit.

The one judgment call is G, and it belongs to the treating provider rather than the coder. Pick the wrong character and the claim tells the payer a different clinical story than the chart does.

This article walks through the code’s meaning, its place in the hierarchy, its siblings, and the documentation that keeps it clean.

What ICD-10 code S62.291G means, and when you can bill it

S62.291G is a billable, specific ICD-10-CM code. It describes an “other fracture” of the first metacarpal bone, right hand. You report it at a follow-up visit where the provider has documented slower-than-expected healing.

Per the CDC/NCHS ICD-10-CM lookup tool, the code is valid in every HIPAA-covered transaction from October 1, 2025.

Billable is not the same as paid. The code clears format edits on a CMS-1500 or an 837P, but coverage policies for fracture follow-up visits still vary by plan. Reimbursement rests on medical necessity, which in practice means the note underneath the code.

Where the code sits in the ICD-10-CM hierarchy

S62.291G is the seventh-character extension of S62.291, inside the injury chapter’s wrist and hand block. Reading the chain upward is the quickest way to confirm you are at the right level of specificity.

The full code runs to seven characters. S62.291 on its own is a header, so a claim carrying it rejects before a payer ever reads it. The CMS ICD-10 codes page publishes the annual tabular list and the update files behind that rule.

Seventh character G says healing slowed, not stopped

Character G marks a follow-up visit where the bone is still knitting, only later than it should. Healing that has genuinely stopped is K, and the two get confused constantly.

The fracture characters split three ways first, into initial encounter, subsequent encounter, and sequela. Within subsequent, the character then reports healing status. The decision runs in that order, so work down it rather than scanning for the label that sounds closest.

One detail catches coders who move between body regions. Hand and wrist fracture codes are not split by Gustilo classification, so there is no type I/II versus type IIIA/B/C pair here. S62 gives you a single open-fracture character, and that character is B.

Key distinction: swapping G in for K overstates the severity on the claim. Swapping D in for G understates the work the provider actually did. Auditors watch both directions, which is why the healing statement in the note matters more than the character itself.

Who decides that healing counts as delayed

The treating provider does. No week count turns D into G, because delayed healing is a clinical determination rather than a deadline.

The ICD-10-CM official guidelines from CDC/NCHS set out the fracture seventh characters and leave that judgment with the clinician. Worth noting: this encounter-based system is specific to ICD-10-CM in the United States. The WHO’s international ICD-10 does not use it, so a coder trained abroad will not recognise the pattern.

Clinical literature generally expects radiographic healing in a metacarpal fracture within four to eight weeks. Age, comorbidities, and fracture pattern all move that window, which is why the guidelines refuse to name a number.

To support character G on S62.291G, the record needs at least one of the following:

• A clinical note saying healing is progressing more slowly than expected for this fracture
• Radiographic findings showing incomplete or absent callus beyond the expected timeframe
• Provider wording such as “delayed union”, “impaired healing”, or “prolonged healing course”
• Continued casting, splinting, or therapy past the standard window, with the reason documented

Without one of those, a payer can reassign or deny the line because the qualifier is unsupported. When the record sits somewhere between routine and delayed, query the provider before you choose.

Other fracture of the first metacarpal is narrower than it sounds

S62.29 is a residual subcategory. It catches first metacarpal fracture patterns that none of the named subcategories describe, and nothing beyond that.

The first metacarpal is the thumb metacarpal, the shortest of the five and the most radially placed. Metacarpals run I to V, thumb to little finger. Thumb fractures carry clinical weight because pinch and grip both depend on that ray.

Subcategory S62.2 splits by fracture pattern before it splits by hand, and each named pattern has its own codes:

• Bennett’s fracture (S62.21-): an intra-articular fracture at the base, involving the carpometacarpal joint. It has dedicated codes and never routes to S62.29-.
• Rolando’s fracture (S62.22-): a comminuted intra-articular base fracture. It also has dedicated codes, so a documented Rolando fracture of the right thumb is S62.221-, not S62.291G.
• Other fracture of the base (S62.23-): a base fracture that is neither Bennett’s nor Rolando’s.
• Shaft fracture (S62.24-) and neck fracture (S62.25-): each pattern has its own subcategory.
• Other fracture (S62.29-): what is left once base, shaft, neck, Bennett’s, and Rolando’s are all excluded.

So the residual code is a last stop, never a default. Read the operative note or the imaging report for the fracture pattern first, and only land on S62.291G when none of the named patterns fit.

The sibling codes you will need at the next visit

S62.291 carries seven billable extensions, and the same set repeats for the left hand under S62.292 and the unspecified hand under S62.299. The AAPC ICD-10-CM lookup lists the whole S62.29 family in one view.

Laterality is not optional here. S62.299G holds up only when the record genuinely never states which hand, which is rare for a thumb injury. If laterality appears anywhere in the chart, code it.

Other fracture sites follow the same seventh-character logic, and our ICD-10 diagnostic code library breaks each one down the same way.

Index entries that route documentation to this code

Providers rarely write in tabular language. These phrasings all land on S62.291G through the alphabetic index:

• Other fracture of right first metacarpal bone, subsequent encounter, delayed healing
• Delayed union, first metacarpal fracture, right hand, subsequent encounter
• Fracture right thumb metacarpal, delayed healing, follow-up visit
• Thumb metacarpal fracture, other type, right, subsequent encounter, delayed union
• Right metacarpal I fracture with delayed healing, subsequent encounter

Before you commit to any of them, the chart has to confirm four facts. Right hand, first metacarpal, a pattern that is neither Bennett’s nor Rolando’s, and provider-documented delayed healing.

How an S62.291G claim moves, and where it stalls

Nothing about this code changes how a claim travels. What changes is where it gets stuck, and it is almost always the same place.

1. The visit. The provider checks the thumb, reviews new imaging, and writes the healing status into the note. Miss that line and the coding decision is already stuck.
2. Charge capture. The diagnosis pairs with what was actually done. A follow-up assessment usually sits on an established-patient office visit code such as CPT code 99213, with an X-ray code added when imaging was taken.
3. Clearinghouse edits. Format checks run first. A truncated S62.291 rejects here, which is the cheapest place to catch it.
4. Payer adjudication. The plan reads the seventh character as a clinical statement. A run of G characters across many months invites a medical necessity review.
5. Remittance. A denial on this line usually points back at the documentation rather than the code choice.

That gives you a short pre-submission routine. Run these five checks before the claim goes out:

• The note names the hand.
• The note names the fracture pattern, and it is not Bennett’s or Rolando’s.
• The provider, not the coder, has called the healing delayed.
• Imaging or a clinical note supports that delay at this visit.
• The code carries all seven characters.

Four of those five are chart problems. Only the last one is a keystroke, which tells you where to spend your review time.

Documentation that keeps the claim clean

The record has to carry three parts of the code description at once. Fracture type, anatomy, and encounter status all need to appear, and a claim built on the code holds up when they do.

What the record must show

• Fracture type: the note must separate this fracture from a Bennett’s fracture. If it says “base fracture” with no further detail, query the provider or read the imaging report.
• Laterality: right hand, stated explicitly. Operative notes, imaging reports, and clinician notes should agree.
• Encounter designation: the visit is a follow-up, not the first definitive treatment. Initial treatment takes character A or B.
• Delayed healing: the provider states that healing is slower than expected. Imaging showing incomplete callus or a persistent fracture line supports it.
• Active care status: the patient is still under treatment and monitoring, rather than in sequela management.

Mistakes that trigger a denial

• G in place of D, with no support. Coding delayed healing over a note that reports routine progress is upcoding, and the payer can pull the record.
• D in place of G, when the note says otherwise. This drops clinically relevant detail and can cost reimbursement for extended management.
• G confused with K. Nonunion needs explicit documentation that union has not occurred and will not without intervention.
• A missing seventh character. S62.291 on its own is invalid, and the claim rejects at the clearinghouse.
• G applied to a Bennett’s fracture. A documented Bennett’s fracture takes the S62.21- series instead.

How Pabau keeps seventh-character fracture claims clean

Most of the work above happens in two places that rarely talk to each other. The healing statement lives in the clinical note, and the claim gets rebuilt somewhere else, often from a superbill written after the fact.

Practice management software like Pabau keeps both on one record. Pabau’s tools for cleaner claims management build the CMS-1500 or 837P line straight from the encounter. The diagnosis you coded is the diagnosis that ships. Eligibility checks run before the visit instead of after the denial.

Remittance advice comes back into the same record. A denial on a fracture line lands next to the note that caused it. The coder reads the reason code and the documentation together, instead of chasing both.

Keep fracture follow-up claims clean

Pabau builds CMS-1500 and 837P claims from the encounter record, checks eligibility before the visit, and returns remittance advice to the same chart. Coders read the note and the denial reason side by side.

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Conclusion

Seventh characters reward reading the chart twice. On S62.291G the code is settled the moment the provider writes that healing has slowed. The coder’s job is to find that line, or to ask for it.

Denials on this code usually trace back to the note rather than the code choice. A follow-up template that prompts for healing status will do more for your clean-claim rate than another cheat sheet.

Book a demo to see how Pabau ties the coded encounter to the claim that goes out.

Continue your research

Not sure what makes a claim clean before it leaves? Clean claim sets out the formatting and documentation checks that stop a rejection at the clearinghouse.

Reading a denial on a fracture line? Denial codes in medical billing maps the reason codes you will meet most often, and the response each one needs.

Coding the first visit for the same thumb? ICD-10 code S62.291B covers the open fracture at the initial encounter, with the same documentation breakdown.

New to electronic claim submission? Claim.MD clearinghouse explains how 837P submission, remittance advice, and eligibility checks fit together.

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