ICD code S62.351D – Nondisplaced second metacarpal shaft fracture

Key takeaways

S62.351D covers follow-up visits for a nondisplaced left second metacarpal shaft fracture that is healing as expected.

The first visit where the fracture is treated takes S62.351A (closed) or S62.351B (open), never D.

The note must name the second metacarpal, the left hand and the shaft, and imaging must support nondisplaced.

Laterality sits in the 6th character, so the same fracture in the right hand codes to S62.350D.

Pabau’s claims software validates each claim before it leaves the practice and links rejected claims straight to the field that needs fixing.

ICD-10 Code S62.351D: Definition and quick-reference table

ICD-10 Code S62.351D is the billable ICD-10-CM diagnosis code for a nondisplaced fracture of the shaft of the second metacarpal bone in the left hand. It applies at a subsequent encounter, once the fracture is healing routinely.

It sits in category S62 (fracture at wrist and hand level) and is valid in the current ICD-10-CM edition. Check it against the CDC/NCHS ICD-10-CM web tool for the fiscal year of the date of service.

In the medical billing process, S62.351D is the diagnosis that supports each follow-up service on the claim. That covers the office visit, a splint change and any therapy billed on the same date.

Anatomy decoded: Shaft, second metacarpal and what nondisplaced means

The second metacarpal is the long bone that connects the wrist (carpals) to the base of the index finger. It’s the longest metacarpal, and its shaft is a common fracture site in direct-impact injuries.

The shaft (also called the body) is the tubular midportion of the bone. It sits between the neck, just below the metacarpal head, and the base, where the bone meets the carpals.

For coding, the fracture site within the bone sets the 5th character. Subcategory S62.3 covers the second to fifth metacarpals and splits displaced from nondisplaced fractures of the base, shaft and neck. The first metacarpal has its own subcategory, S62.2, and fractures of the finger and thumb phalanges sit in S62.5 and S62.6. For example, a nondisplaced base fracture of the right fifth metacarpal at the initial encounter for an open fracture codes to S62.346B code.

Applying S62.351D to a neck fracture is a specificity error, because a nondisplaced neck fracture of the left second metacarpal codes to S62.361D.

The diagram below decodes S62.351D one character at a time, including where laterality sits.

Nondisplaced defined: A nondisplaced fracture has a fracture line, but the bone fragments haven’t shifted from their normal alignment. The cortex may be cracked or buckled without separation or angulation.

The treating provider establishes this from imaging, not the coder. The coder assigns the displacement character from the provider’s interpretation of the imaging report.

• Radiographic language signaling nondisplaced: “no displacement,” “hairline fracture,” “cortical breach without fragment shift,” “non-angulated,” “buckle fracture without deformity”
• Radiographic language signaling displaced: “displaced,” “angulated,” “fragment separation,” “bayonet apposition,” “shortening”
• If ambiguous: Query the treating provider before assigning a code. If the record still doesn’t say, the ICD-10-CM guidelines default the fracture to displaced (S62.321D) and to closed.

Understanding the 7th character: Seven phases of fracture care

The 7th character in S62.351 sets the phase of care, and payers check it against the services on the claim. Seven 7th characters are valid for S62.351 (A, B, D, G, K, P and S). Three of them describe active treatment or late effects, and four describe how a healing fracture is progressing.

When D starts: The switch from A to D isn’t triggered by a calendar date or a number of weeks. It’s triggered by the phase of care. Section I.C.19 of the ICD-10-CM Official Guidelines for Coding and Reporting applies D once active treatment is complete. From then on, the patient receives routine care while the fracture heals.

A cast check at week two already falls in the subsequent-encounter phase, so D applies there. A provider who starts fracture treatment for the first time uses A, even if the injury is weeks old.

S62.351D vs adjacent codes: How to choose the right code

Several codes surround S62.351D in the tabular list, and picking the wrong one misreports the injury even when the claim pays. The table below compares the codes most often confused with it, along with the one axis that separates each.

Telling the second metacarpal from the third gets harder when the note says “index finger” or “long finger” without naming the bone. The second metacarpal belongs to the index finger, and the third belongs to the middle (long) finger. When the note is ambiguous about the digit, query the provider before assigning the code.

Documentation that supports S62.351D

Supporting documentation must establish four elements of S62.351D: the bone, the hand, the site within the bone and the phase of care. For this code those are the second metacarpal, the left hand, the shaft and a routine-healing follow-up. A record missing any one of them leaves the code exposed in a retrospective audit.

• Fracture location specificity: The note must name the second metacarpal, the left hand and the shaft or body as the fracture site. Phrases like “hand fracture” or “metacarpal fracture” without further detail don’t support this code.
• Displacement status: The treating provider’s reading of the imaging (X-ray or CT) must state that the fracture is nondisplaced, or use equivalent language. Don’t infer displacement status from the mechanism of injury.
• Phase of care confirmation: The note should document that this is a follow-up visit for an established fracture. Language like “presenting for cast check” or “follow-up for left index finger metacarpal fracture diagnosed [date]” substantiates the D character.
• Fracture management plan: The visit record should document the current management status. That includes the cast or splint in place, immobilization instructions, any therapy referral, return-to-activity guidance or a plan for imaging review.
• Imaging on this visit (if obtained): If new X-rays were taken at this follow-up visit, note the findings and whether they confirm healing progress.

What payers check on S62.351D claims

CMS and most major commercial payers follow the ICD-10-CM Official Guidelines when they review subsequent-encounter fracture claims. For S62.351D, their checks center on code specificity, CPT-to-ICD matching, visit frequency and global surgery period compliance.

• Specificity match: Payers increasingly apply clinical logic edits that check whether the ICD-10 code matches what the CPT code implies. A fracture care CPT code submitted with an unspecified fracture code may trigger a review that S62.351D would have avoided.
• Visit frequency reasonableness: Several subsequent-encounter claims for the same fracture within a short window may be reviewed against clinical norms for metacarpal healing. Document the clinical reason for each visit.
• Global surgery period: When the same provider performed the initial fracture treatment (CPT 26600 or 26605), follow-up E/M visits in the global period are bundled. Providers who didn’t perform the initial fracture care generally aren’t bound by that global period.
• Coverage determinations: No national coverage determination (NCD) governs routine metacarpal fracture follow-up. If you bill Medicare, check your MAC’s local coverage determinations (LCDs) alongside the CMS ICD-10 codes page.

Common CPT codes paired with S62.351D

The CPT codes submitted alongside S62.351D depend on the service rendered at the follow-up visit. The most common pairings fall into three groups: evaluation and management (E/M) visits outside a global period, cast and splint codes, and therapy procedure codes.

Closed treatment of the fracture without manipulation is billed under CPT 26600, which carries a 90-day global period. Follow-up visits by the same provider in that window are part of the surgical payment. Those visits are usually reported with CPT 99024 (postoperative follow-up visit) rather than a billable E/M code. If the fracture was pinned through the skin, the procedure is billed under percutaneous fixation code 26608 instead.

Why claims are denied and how to fix them

S62.351D denials follow predictable patterns, and most trace back to five root causes. Knowing them lets you build a pre-submission checklist instead of an appeals queue. Strong denial management workflows start before the claim is submitted, not after the explanation of benefits arrives.

When a denial arrives via electronic remittance advice, check its claim adjustment reason code (CARC) first. CARC 97 (benefit included in another service) usually means a global period overlap. CARC 96 (non-covered charges) points to a coverage limit in the patient’s plan.

CARC 16 (claim lacks information) and CARC 252 (an attachment or other documentation is required) mean the payer wants more records. A prior authorization denial comes back as CARC 197.

Coding tips for clean S62.351D claims

Accurate reimbursement on S62.351D comes down to a routine you run before each follow-up claim goes out.

• Verify displacement status from the imaging report, not the clinical note alone. Providers sometimes document “fracture” without displacement language. Read the radiology report first, then cross-check it with the provider’s assessment.
• Confirm the metacarpal number from the anatomy in the note. “Index finger metacarpal” means the second metacarpal. “Middle finger metacarpal” or “long finger metacarpal” means the third, which codes to S62.353D for this left-hand scenario.
• Read laterality from the 6th character. In S62.35-, the 6th character names both the metacarpal and the hand, so 0 is the right second metacarpal and 1 is the left. Never add a modifier or an extra character for laterality on the diagnosis.
• Use D for routine healing visits. Every visit after active treatment ends is a subsequent encounter, however many weeks have passed or providers have seen the patient. Switch to G, K or P only when the provider documents delayed healing, nonunion or malunion.
• Apply S (sequela) only after the fracture has healed. Sequela codes cover treatment of residual effects of a healed fracture, such as stiffness. Using S while the fracture is still healing is a coding error that may not trigger a denial but will fail a medical record audit.
• Check the global period before billing E/M. Look up the global days for the fracture treatment code in the CMS Physician Fee Schedule lookup. Then confirm whether that period applies to the billing provider.

Submitting a clean claim on the first pass means verifying five elements before the claim leaves the practice. They are the code, the encounter character, the CPT pairing, the supporting documentation and global period compliance. Clearinghouse edits catch code-level errors, but they can’t confirm that the note supports the code.

How Pabau keeps S62.351D follow-up claims clean

Fracture aftercare means the same diagnosis goes out on claim after claim. Each cast check is another chance for an A to slip in where a D belongs. The error only surfaces when the remittance comes back.

Pabau, the practice management platform we build, handles end-to-end claims management for US practices. Each claim opens pre-filled from the visit’s invoice, and claim validation scrubs it for missing or invalid details before it leaves. Claims then reach US payers through Claim.MD, our clearinghouse partner.

If a payer rejects a claim, Pabau flags it as Needs action and links straight to the field that needs correcting. Eligibility checks run before the visit, and electronic remittance advice comes back against each claim. So your billing team fixes a rejected follow-up claim from one screen instead of rebuilding it from the chart.

Reduce claim denials for fracture aftercare visits

Pabau pre-fills each claim from the visit’s invoice, validates it before submission and sends it through Claim.MD. Follow-up fracture claims go out complete the first time.

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Conclusion

S62.351D fails in a few predictable ways. The usual culprits are the wrong 7th character, the wrong hand, an unspecified code, or a displacement status the imaging doesn’t support. Each one costs less to catch before submission than to appeal after a denial.

So make the imaging report and the last two characters of the code your first check on every follow-up claim. Those two characters carry the hand and the phase of care, and they change more often than the rest of the code.

Book a demo to see how Pabau validates fracture follow-up claims before they reach the payer.

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