FY2027 ICD-10-CM reference
S32.018B: Other fracture of first lumbar vertebra, initial encounter for open fracture
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Other fracture of first lumbar vertebra, initial encounter for open fracture. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
Source: S00-T88 (chapter, inherited).
Instructional note
code to identify any retained foreign body, if applicable (Z18.-)
Source: S00-T88 (chapter, inherited).
Excludes2
birth trauma (P10-P15)
Source: S00-T88 (chapter, inherited).
Excludes2
obstetric trauma (O70-O71)
Source: S00-T88 (chapter, inherited).
Instructional note
The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
Source: S00-T88 (chapter, inherited).
Includes
injuries to the abdominal wall
Source: S30-S39 (section, inherited).
Includes
injuries to the anus
Source: S30-S39 (section, inherited).
Includes
injuries to the buttock
Source: S30-S39 (section, inherited).
Includes
injuries to the external genitalia
Source: S30-S39 (section, inherited).
Includes
injuries to the flank
Source: S30-S39 (section, inherited).
Includes
injuries to the groin
Source: S30-S39 (section, inherited).
Excludes2
burns and corrosions (T20-T32)
Source: S30-S39 (section, inherited).
Excludes2
effects of foreign body in anus and rectum (T18.5)
Source: S30-S39 (section, inherited).
Excludes2
effects of foreign body in genitourinary tract (T19.-)
Source: S30-S39 (section, inherited).
Excludes2
effects of foreign body in stomach, small intestine and colon (T18.2-T18.4)
Source: S30-S39 (section, inherited).
Excludes2
frostbite (T33-T34)
Source: S30-S39 (section, inherited).
Excludes2
insect bite or sting, venomous (T63.4)
Source: S30-S39 (section, inherited).
Instructional note
A fracture not indicated as displaced or nondisplaced should be coded to displaced
Source: S32 (category, inherited).
Instructional note
A fracture not indicated as opened or closed should be coded to closed
Source: S32 (category, inherited).
Includes
fracture of lumbosacral neural arch
Source: S32 (category, inherited).
Includes
fracture of lumbosacral spinous process
Source: S32 (category, inherited).
Includes
fracture of lumbosacral transverse process
Source: S32 (category, inherited).
Includes
fracture of lumbosacral vertebra
Source: S32 (category, inherited).
Includes
fracture of lumbosacral vertebral arch
Source: S32 (category, inherited).
Code first
any associated spinal cord and spinal nerve injury (S34.-)
Source: S32 (category, inherited).
Excludes1
transection of abdomen (S38.3)
Source: S32 (category, inherited).
Excludes2
fracture of hip NOS (S72.0-)
Source: S32 (category, inherited).
Seventh-character instruction
The appropriate 7th character is to be added to each code from category S32
Source: S32 (category, inherited).
Instructional note
initial encounter for closed fracture
Source: S32 (category, inherited).
Instructional note
initial encounter for open fracture
Source: S32 (category, inherited).
Instructional note
subsequent encounter for fracture with routine healing
Source: S32 (category, inherited).
Instructional note
subsequent encounter for fracture with delayed healing
Source: S32 (category, inherited).
Instructional note
subsequent encounter for fracture with nonunion
Source: S32 (category, inherited).
Instructional note
sequela
Source: S32 (category, inherited).
Instructional note
Fracture of lumbar spine NOS
Source: S32.0 (self, inherited).
Seventh-character definitions
- 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
Compare the FY2027 additions, removals and billable-status changes
What does S32.018B mean in FY2027?
The official ICD-10-CM descriptor is Other fracture of first lumbar vertebra, initial encounter for open fracture. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is S32.018B billable in FY2027?
The FY2027 order file marks S32.018B as billable. Check the complete Tabular instructions and documentation before assigning it.
Does S32.018B map to an HCC?
In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), S32.018B maps to CMS-HCC V28 HCC 401 (Vertebral Fractures without Spinal Cord Injury). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.
Review the FY2026 April edition