S89.049A Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, initial encounter for closed fracture

Billable ICD-10-CM code, FY2026.

Built from S89.049 with 7th character A (initial encounter for closed fracture).

Applies from S89 Other and unspecified injuries of lower leg

Excludes2 (not included here)

• other and unspecified injuries of ankle and foot (S99.-)

7th character note

• The appropriate 7th character is to be added to each code from subcategories S89.0, S89.1, S89.2, and S89.3

Notes

• A fracture not indicated as open or closed should be coded to closed

7th character required

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

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to S89.049A

Back-references to S89.0

• Type 2 Excludes: S82.1 Fracture of upper end of tibia ("physeal fracture of upper end of tibia (S89.0-)")

Back-references to S89

• Type 2 Excludes: M23 Internal derangement of knee ("current injury - see injury of knee and lower leg (S80-S89)")

Nearby codes

• S89.042G Salter-Harris Type IV physeal fracture of upper end of left tibia, subsequent encounter for fracture with delayed healing
• S89.042K Salter-Harris Type IV physeal fracture of upper end of left tibia, subsequent encounter for fracture with nonunion
• S89.042P Salter-Harris Type IV physeal fracture of upper end of left tibia, subsequent encounter for fracture with malunion
• S89.042S Salter-Harris Type IV physeal fracture of upper end of left tibia, sequela
• S89.049 Salter-Harris Type IV physeal fracture of upper end of unspecified tibia
• S89.049A Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, initial encounter for closed fracture (this code)
• S89.049D Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with routine healing
• S89.049G Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with delayed healing
• S89.049K Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with nonunion
• S89.049P Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, subsequent encounter for fracture with malunion
• S89.049S Salter-Harris Type IV physeal fracture of upper end of unspecified tibia, sequela