ICD code S62.357B – Nondisplaced fracture of shaft of fifth metacarpal bone

Key takeaways

S62.357B is a billable ICD-10-CM code for a nondisplaced fracture of the left fifth metacarpal shaft, initial encounter for open fracture.

The 7th character B marks an open fracture at the initial encounter, while character A covers closed fractures.

Laterality is built into the code. S62.357 covers the left hand and S62.356 covers the right.

The note must show that the wound connects to the fracture site, because ICD-10-CM defaults to closed when it does not.

Practice management software like Pabau carries the selected ICD-10-CM code straight onto the CMS-1500 claim, so nobody rekeys it.

ICD-10 Code S62.357B: code at a glance

S62.357B is a specific, billable code, so it needs no further character to stand on a claim. The table below summarizes the data points a coder checks before submission.

Code hierarchy and parent codes for S62.357B

Knowing where S62.357B sits in the ICD-10-CM tabular list is how coders confirm they have reached the most specific code available. S62.357B is a complete 7-character code, so no more specific option exists.

The parent code S62.357 is non-billable without a 7th character. As a result, coders must append the right one for the claim to clear the payer edits. The CMS ICD-10 codes page publishes the full FY2026 tabular list and the annual update files.

Understanding the 7th character: what does “B” mean in ICD-10 Code S62.357B?

In fact, the 7th character is where most metacarpal fracture claims go wrong. For every S62.357 code, that character sets both the fracture type and the encounter type. Character B means initial encounter for open fracture.

The A/B/D/G/K/P/S set is specific to US ICD-10-CM. The ICD-10-CM Official Guidelines published by CMS and NCHS define the initial encounter as the period of active treatment. That covers emergency department visits, surgical treatment, and the first outpatient visit where treatment actually begins. The WHO version of ICD-10 has no matching 7th character.

The table below lists every valid 7th character for S62.357.

S62.357A vs S62.357B: key differences

In practice, confusing A and B is the most common coding error on fifth metacarpal fracture claims. Both cover initial encounters, but they describe different wound types with different notes and payment outcomes.

Critical rule: per ICD-10-CM Official Guidelines Section I.C.19, a note that does not specify open or closed defaults to closed. Therefore, select S62.357B only when the record shows an open wound connecting to the fracture site.

Approximate synonyms and clinical terminology for fifth metacarpal fractures

Coders and clinicians often use different words for the same injury. These are the accepted synonyms and index entry terms tied to S62.357B. Recognizing them keeps code selection accurate when a note is written in clinical shorthand.

• Boxer fracture (common clinical synonym, often the fifth metacarpal neck, though sometimes used loosely for shaft fractures)
• Brawler’s fracture
• Fracture of shaft of fifth metacarpal, open, nondisplaced
• Nondisplaced fracture fifth metacarpal shaft, open, initial encounter
• 5th metacarpal bone shaft fracture, open (nondisplaced)
• Metacarpal V shaft fracture, compound, nondisplaced
• Open fracture fifth metacarpal, nondisplaced, shaft

However, in orthopedic literature, boxer fracture refers to the fifth metacarpal neck. When the note names the neck rather than the shaft, a different S62 code applies. Confirm the anatomical location before coding.

Clinical overview: nondisplaced fifth metacarpal shaft fracture

A nondisplaced fracture means the bone has cracked but the fragments have not shifted out of alignment. In the fifth metacarpal shaft, that often follows a direct blow, a crush injury, or a punch. The periosteum and surrounding soft tissue often stay intact, so these fractures often respond to conservative treatment.

By contrast, open fractures carry more risk. The wound gives contamination a route to the bone, which changes treatment urgency and the surgical approach. For coders, the open status has to appear in the operative or emergency note before S62.357B can replace S62.357A.

• Mechanism: direct blow, crush injury, or punching impact
• Presentation: dorsal hand swelling, point tenderness over the shaft, limited grip
• Imaging: plain radiographs (AP, lateral, oblique), with CT if comminution is suspected
• Conservative treatment: buddy taping or an ulnar gutter splint for stable nondisplaced patterns
• Surgical treatment: open reduction with internal fixation for unstable or open fractures

Documentation requirements for S62.357B

Claims carrying S62.357B draw more scrutiny than closed fractures do, because open status changes both treatment complexity and payment. Consequently, the note has to support every component of the code.

A structured note that captures each of the fields below is much harder for a payer to send back.

• Anatomical location: state “fifth metacarpal” and “shaft”, not neck, head, or base
• Displacement status: document “nondisplaced” from the imaging report, not from clinical impression alone
• Open fracture confirmation: the note must describe an open wound connecting to the fracture site, and wound photos or an operative description strengthen the record
• Encounter type: confirm this is the initial encounter for active treatment, not a follow-up visit
• Laterality: S62.357B is the left hand, so the note must name the side before the code is chosen
• Imaging reference: cite the radiograph report that confirms the nondisplaced pattern

ICD-10-CM coding guidelines for fractures

The FY2026 ICD-10-CM Official Guidelines, Section I.C.19, govern fracture coding across the whole S00-T88 chapter. Five rules decide whether S62.357B survives a payer review.

• Default: displaced. A fracture not documented as displaced or nondisplaced defaults to displaced. S62.357B is a nondisplaced code, so the word has to appear in the record.
• Default: closed. A fracture not documented as open or closed defaults to closed. S62.357B needs clear open fracture documentation.
• 7th character rules. The character must reflect fracture type and encounter type at the date of service. Using B for a follow-up visit is an error, since subsequent encounters take D, G, K, or P.
• External cause codes. The guidelines recommend reporting an external cause code alongside S62.357B to identify the mechanism of injury.
• Sequencing. Where S62.357B is the principal diagnosis, it goes first on the claim, followed by any associated injury codes and then the external cause codes.

The CDC/NCHS ICD-10-CM web tool lets coders check code validity, effective dates, and tabular list notes by fiscal year.

Billing and claim submission for ICD-10 Code S62.357B

S62.357B is valid on both the CMS-1500 professional claim and the UB-04 institutional claim. Open fracture claims draw more payer review than closed ones, so the notes have to be complete before the claim goes out.

Practices that submit electronically send claims through a clearinghouse rather than to each payer directly. Pabau connects to Claim.MD, which submits and tracks claims across more than 4,000 US payers using the codes the practice has already recorded. Watching which denial codes come back on open fracture claims tells you which note field the payer keeps missing.

On inpatient claims, S62.357B is not POA exempt, so the present-on-admission indicator has to be assigned. A review queue for open fracture codes flags notes where wound detail is thin before the claim is submitted.

Commonly used CPT codes with S62.357B

First, an ICD-10-CM diagnosis code has to pair with a CPT procedure code on the claim. Instead, the CPT code follows the treatment actually rendered, not the diagnosis. These are the codes most often paired with fifth metacarpal fracture care. Check current payer policy and the CPT 2026 manual before submission.

CPT pairings follow the procedure performed, not the diagnosis alone. Confirm each one against the AAPC Codify ICD-10-CM lookup and your payer’s local coverage determinations. Where debridement is billed at the same encounter, CPT 97597 carries its own documentation rules for wound surface area.

Sibling and related codes for S62.357B

The S62.35 subcategory covers nondisplaced shaft fractures of the second through fifth metacarpals, which ICD-10-CM groups as the other metacarpal bones. Each bone has a right-hand code and a left-hand code. The grid below shows which one applies before the 7th character is appended.

Every one of these codes takes the same 7th character set, so B always means the initial encounter for an open fracture.

How Pabau carries S62.357B from the note to the claim

In most practices the coder reads the operative note in one system and types the ICD-10 code into another. So, every retype is a chance to drop the B, or to pick S62.356B for a left hand.

Pabau keeps the encounter note, the diagnosis code, and the claim inside one patient record. The code attached in the note is the code that reaches the CMS-1500, and the Claim.MD connection submits and tracks it from there.

That gives hand-injury billing smoother claims management. Fewer claims come back over a mismatch between the operative report and the code on the line. The ones that do are quicker to trace.

Keep the coded diagnosis intact from note to claim

Pabau attaches the ICD-10-CM code to the clinical note and carries it through to claim submission via Claim.MD, which reaches more than 4,000 US payers. See how the billing workflow handles orthopedic and hand injury claims end to end.

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Conclusion

In short, two facts in the record decide S62.357B. The wound must connect to the fracture site, and the injury must be on the left hand.

If either is missing, the correct code is S62.357A or S62.356B, and a payer will often find the difference before you do. Reading the operative report before the code goes on the claim is the cheapest control available.

Book a demo to see how Pabau keeps the coded diagnosis attached to the claim for hand and orthopedic injuries.

Continue your research

Coding another hand fracture? ICD-10 Code S62.233B covers the first metacarpal, left hand, under the same 7th character rules.

Want to understand how clearinghouse submissions reduce denial risk? Claim.MD clearinghouse overview explains how electronic claims move from the practice to the payer.

Looking for a denial prevention framework for hand and orthopedic claims? Denial management in healthcare outlines the workflows that prevent open fracture claim rejections.

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