S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture

Billable ICD-10-CM code, FY2026.

Built from S32.049 with 7th character A (initial encounter for closed fracture).

Applies from S32 Fracture of lumbar spine and pelvis

Includes

• fracture of lumbosacral neural arch
• fracture of lumbosacral spinous process
• fracture of lumbosacral transverse process
• fracture of lumbosacral vertebra
• fracture of lumbosacral vertebral arch

Excludes1 (never code together)

• transection of abdomen (S38.3)

Excludes2 (not included here)

• fracture of hip NOS (S72.0-)

Code first

• any associated spinal cord and spinal nerve injury (S34.-)

7th character note

• The appropriate 7th character is to be added to each code from category S32

Notes

• A fracture not indicated as displaced or nondisplaced should be coded to displaced
• A fracture not indicated as opened or closed should be coded to closed

7th character required

• A — initial encounter for closed fracture
• B — initial encounter for open fracture
• D — subsequent encounter for fracture with routine healing
• G — subsequent encounter for fracture with delayed healing
• K — subsequent encounter for fracture with nonunion
• S — sequela

Applies from S32.0 Fracture of lumbar vertebra

Applicable to

• Fracture of lumbar spine NOS

Risk adjustment (HCC)

• CMS-HCC V28: HCC 401 — Vertebral Fractures without Spinal Cord Injury
• CMS-HCC V22: HCC 169 — Vertebral Fractures without Spinal Cord Injury
• ESRD V24: HCC 169

Code annotations containing back-references to S32.049A

Back-references to S32.0

• Type 1 Excludes: M48.4 Fatigue fracture of vertebra ("traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)")
• Type 2 Excludes: S33.1 Subluxation and dislocation of lumbar vertebra ("fracture of lumbar vertebrae (S32.0-)")
• Code Also: S34 Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level ("fracture of vertebra (S22.0-, S32.0-)")

Back-references to S32

• Type 1 Excludes: M48.5 Collapsed vertebra, not elsewhere classified ("traumatic fracture of vertebra (S12.-, S22.-, S32.-)")
• Type 1 Excludes: M84.3 Stress fracture ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")
• Type 1 Excludes: M84.4 Pathological fracture, not elsewhere classified ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")
• Use Additional: S38.1 Crushing injury of abdomen, lower back, and pelvis ("fracture of thoracic or lumbar spine and pelvis (S22.0-, S32.-)")

Diagnosis Index entries for S32.049A

• Fracture, traumatic (abduction) (adduction) (separation) › vertebra, vertebral (arch) (body) (column) (neural arch) (pedicle) (spinous process) (transverse process) › lumbar › fourth

Nearby codes

• S32.048D Other fracture of fourth lumbar vertebra, subsequent encounter for fracture with routine healing
• S32.048G Other fracture of fourth lumbar vertebra, subsequent encounter for fracture with delayed healing
• S32.048K Other fracture of fourth lumbar vertebra, subsequent encounter for fracture with nonunion
• S32.048S Other fracture of fourth lumbar vertebra, sequela
• S32.049 Unspecified fracture of fourth lumbar vertebra
• S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture (this code)
• S32.049B Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture
• S32.049D Unspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with routine healing
• S32.049G Unspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with delayed healing
• S32.049K Unspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with nonunion
• S32.049S Unspecified fracture of fourth lumbar vertebra, sequela