ICD-10 code S68.612S: Right middle finger amputation, sequela

Key takeaways

S68.612S is the ICD-10-CM code for a complete traumatic transphalangeal amputation of the right middle finger, sequela.

The sixth character 2 names the right middle finger specifically. The genuine “other finger” code is S68.618, and its sequela form is S68.618S.

S68.612S is billable under the FY2026 ICD-10-CM edition, effective October 1, 2025, on both CMS-1500 and UB-04 claim forms.

Use S68.612S only for a late effect of the injury, such as phantom pain, scar contracture, or grip loss. It never covers the original injury.

Practice management software like Pabau captures the diagnosis code at the point of care, so laterality and encounter type reach the claim intact.

ICD-10 code S68.612S: Definition and billable status

ICD-10-CM code S68.612S means complete traumatic transphalangeal amputation of the right middle finger, sequela. It describes a healed amputation through a phalanx of the right third digit. You assign it at a later visit, for a residual effect of that injury.

The code is billable and diagnosis-specific under the FY2026 ICD-10-CM edition, which took effect on October 1, 2025. Payers accept it on both the CMS-1500 and the UB-04 claim form.

One detail causes most of the errors on this code. S68.612 does not mean “other finger.” That phrase belongs to the S68.61 rubric title, which sits one level up and covers ten child codes. Read the sixth character instead. The 2 in S68.612 means the right middle finger.

S68.612S code details at a glance

The table below collects the facts a coder or clinician needs before putting S68.612S on a claim.

What does S68.612S mean?

Every character in S68.612S carries a specific clinical meaning. Misreading any one of them changes which digit, which hand, or which encounter is being described.

• S68 – Traumatic amputation of wrist, hand, and fingers (category)
• .6 – Traumatic transphalangeal amputation of other and unspecified finger (subcategory: the cut runs through a phalanx)
• 1 – Complete amputation, as opposed to partial
• 2 – Right middle finger; this character carries both the digit and the side
• S – Seventh character: sequela encounter

Which finger does S68.612 identify?

S68.612 identifies the right middle finger, also called the right long finger or the third digit of the right hand. Laterality is already inside the code, so no separate side code is needed.

The confusion comes from the heading one level up. S68.61 is titled “Complete traumatic transphalangeal amputation of other and unspecified finger(s).” That title describes the whole block of child codes, S68.610 through S68.619. It is not the description of any single code inside it.

The specific “other finger” code is S68.618, and its sequela form is S68.618S. Reserve it for a documented digit that none of the eight named codes covers, such as a supernumerary finger. If the record never identifies the digit, use S68.619S instead. The table below maps every sixth character in the series.

The thumb sits outside this subcategory. A complete transphalangeal amputation of the right thumb is S68.511, and the left thumb is S68.512.

What is a transphalangeal amputation?

A transphalangeal amputation passes through the shaft of a phalanx rather than through an interphalangeal joint. The bone itself is cut, not disarticulated at a joint line. That level differs from a transmetacarpal amputation, which runs through the metacarpal bones, and from a disarticulation at the joint.

The “complete” qualifier means the digit is entirely severed. Partial transphalangeal amputations belong in the S68.62 series, where S68.622 is the right middle finger.

Seventh character S: sequela encounter

Selecting the correct seventh character is where most coder errors occur with trauma-related ICD-10 codes. Every S68.612 encounter takes one of three seventh characters, each tied to a distinct clinical scenario.

S68.612A vs S68.612D vs S68.612S: which code to use?

The critical distinction between D and S is wound status. Seventh character D applies while healing is ongoing. Once the amputation site is fully healed and the patient returns for a residual condition, switch to S68.612S. Under CMS ICD-10 coding guidance, a sequela encounter sequences the residual condition first, with S68.612S listed as the cause.

Code hierarchy and classification

Understanding the ICD-10-CM diagnostic code structure helps coders place S68.612S correctly on a claim and cross-reference it accurately in the medical record.

• S00-T88 – Injury, poisoning, and certain other consequences of external causes (chapter)
• S60-S69 – Injuries to the wrist, hand, and fingers (block)
• S68 – Traumatic amputation of wrist, hand, and fingers (category)
• S68.6 – Traumatic transphalangeal amputation of other and unspecified finger (subcategory)
• S68.61 – Complete traumatic transphalangeal amputation of other and unspecified finger(s); a rubric heading covering S68.610 through S68.619, not a code you assign
• S68.612 – Complete traumatic transphalangeal amputation of right middle finger (six-character code, still needs a seventh character)
• S68.612S – Complete traumatic transphalangeal amputation of right middle finger, sequela (billable code)

The CDC/NCHS ICD-10-CM web tool lets coders walk this hierarchy from the tabular list. It also confirms that S68.612S remains a billable specific code for the current fiscal year.

Related and sibling ICD-10 codes for traumatic finger amputation

S68.612S sits inside a larger family of hand amputation codes, split by amputation level and by completeness. ICD-10 sequela coding patterns follow the same A/D/S logic across the whole S68 category, so every code below takes a seventh character too.

The AAPC ICD-10-CM code lookup carries the full S68 range with descriptions and coding notes for each sibling code.

Applicable to notes and coding inclusions for S68.612S

The S68 tabular list entry carries notes that widen what can be coded here, and others that call for a second code. Review them before defaulting to an unspecified code.

• Coding convention – An amputation not identified as partial or complete is coded to complete, which puts it in the S68.61 series rather than S68.62
• Use additional code – For any associated wound infection
• Use additional code – For a retained foreign body, if applicable (Z18.-)
• External cause code – May be added to identify the mechanism of injury, such as industrial equipment, a power saw, or machinery

There are no Excludes1 notes at the S68.612S code level. The tabular list separates neighboring injuries structurally instead. A transphalangeal thumb amputation belongs in the S68.5 series, and an amputation of the hand at wrist level belongs in S68.4. Always verify against the official CMS tabular list or a maintained reference such as ICD List before submitting.

ICD-10-CM official coding guidelines for traumatic amputations

ICD-10-CM Official Coding Guidelines Section I.C.19 governs injury codes, including traumatic amputations. Medical billing compliance with these guidelines decides whether a claim is paid on first submission. The key rules for S68.612S follow.

• Sequela sequencing rule – Code the residual condition first, such as phantom pain or scar contracture. S68.612S follows it as the secondary code that identifies the originating injury.
• Healing vs sequela boundary – A sequela code is not used while the injury is still healing, even if complications arise. Use seventh character D until the record documents complete healing.
• Laterality is not optional – The sixth character already fixes the side. If the note says left middle finger, the code is S68.613S, and no side modifier can rescue the wrong digit.
• No acute injury code – S68.612S should never stand alone on a claim for an acute event. In a sequela encounter it always pairs with a condition code.
• Multiple codes for multiple sequelae – A patient with both phantom pain and scar contracture gets both condition codes. Each is followed by S68.612S as the causative injury code.

The CMS ICD-10 official code files publish the FY2026 guidelines. Sequela rules are reviewed at each annual update, so check the current file rather than a saved copy.

Documentation requirements for S68.612S

To hold up on audit, the record must justify all five parts of the code. HIPAA-compliant medical documentation standards also require the record to be legible, dated, and authored by a qualified clinician. The specific elements for this code follow.

• Mechanism of injury – The original trauma type, such as industrial machinery, a power tool, or a crush injury, plus the date
• Digit and side named – “Right middle finger” or “right third digit”; a note that says only “finger” will not support S68.612S
• Completeness of amputation – The operative or emergency report confirming the digit was completely severed through the phalanx
• Healed status – A clinical note, discharge summary, or wound-check entry showing the site fully healed before sequela coding began
• Sequela condition – The late effect being treated: phantom limb pain, scar contracture, neuroma, reduced grip strength, or functional deficit

Using digital intake and clinical forms at each follow-up captures wound status and sequela conditions at the point of care. That beats reconstructing them from memory at billing time, and practices that standardize it see fewer audit findings on sequela codes.

Claim form submission: CMS-1500 and UB-04

S68.612S is valid on both major US claim forms. What matters is which box the code goes in, and in which position. Our CMS-1500 form guide walks through the diagnosis fields box by box.

Most state workers’ compensation payers accept S68.612S. Sequela rules can still intersect with state causation standards, so verify with the specific payer first. Workers’ compensation forms and sequencing requirements vary by jurisdiction.

Pabau’s claims management software supports ICD-10 entry inside the patient record. The sequela code and its condition code stay together, in the right order, on either claim form.

Common CPT codes used with S68.612S

S68.612S is a diagnosis code, not a procedure code. It says why a service was provided, and it pairs with CPT codes that say what was done. For physical therapy and rehabilitation practices treating the sequela of a finger amputation, the table below lists the usual pairings. They are representative, not payer-mandated.

One pairing detail is easy to miss. Hand procedure codes take an anatomical digit modifier, and for the right middle finger that modifier is F7. If the diagnosis says right middle finger, the procedure line should say F7, or the claim contradicts itself.

For workers’ compensation sequela encounters, the established-patient visit codes are the most common pairing with S68.612S. Therapy codes 97110 and 97140 apply when the visit involves active rehabilitation rather than evaluation alone. Verify every pairing against current NCCI edits and payer local coverage determinations before submitting.

Consistent medical forms and documentation workflows capture the CPT service and the ICD-10 diagnosis in the same place, at the same visit. That is what turns a coded encounter into a clean claim on first submission.

Common coding errors and how to avoid them

Five mistakes account for most rejected S68.612S claims. Four of them are visible in the record before the claim goes out.

• Reading S68.612 as “other finger” – The phrase belongs to the S68.61 rubric, which spans ten codes. Assign S68.618S for a documented digit outside the eight named ones, and S68.612S only for the right middle finger.
• Losing laterality – S68.612S is the right hand only. A left middle finger sequela is S68.613S, and a swapped side is a clinical error, not a typo.
• Keeping D after the site heals – Once a note records complete healing, later visits for a late effect take S and not D.
• Sequencing S68.612S first – The residual condition leads on a sequela claim. S68.612S explains its cause and sits behind it.
• Coding complete when the report says partial – Read the operative report before defaulting to the S68.61 series. A partial amputation of the same digit is S68.622S.

Every one of these rejections lands in the same place. It reaches your denial management queue weeks after the visit, once the clinician who saw the patient has moved on.

How Pabau keeps S68.612S claims documented and submitted

In most practices the diagnosis code is chosen after the visit, from a note written hours earlier. Digit, side, and wound status are the first details to go missing. A sequela code with no healed-status note is also the first thing an auditor asks about.

Pabau keeps the code with the encounter that produced it. Clinicians record the digit, the side, and the healed status on a structured form during the visit itself. Your coding team then works from the record rather than from recall, so S68.612S and S68.613S never get confused after the fact.

Claims leave the practice through our Claim.MD integration, so a coded encounter reaches the clearinghouse without re-entry. Remittances and rejections come back into the same patient record, which shortens the loop when something does need reworking.

The outcome is fewer first-pass rejections on trauma and sequela claims. Your team also spends less time reconstructing what a note should have said months ago.

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Conclusion

S68.612S is narrower than its parent rubric suggests. It means one digit on one hand: a healed complete transphalangeal amputation of the right middle finger, coded for a late effect. Anything broader belongs in S68.618S or S68.619S.

Get two things right and this code rarely comes back. Confirm the digit and side against the operative note. Then check that a clinician documented complete healing before you switch the seventh character to S.

Pabau’s practice management software helps billing teams capture ICD-10 codes accurately at the point of care and submit them in the right order. To see how it handles trauma and sequela billing, book a demo.

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