S34.124A

Incomplete lesion of L4 level of lumbar spinal cord, initial encounter

FY2027Chapter 19: Injury, poisoning and certain other consequences of external causes/S30–S39 Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals

BillableComplete code, valid to report

S34.124A (also written S34124A) is a billable ICD-10-CM diagnosis code for incomplete lesion of L4 level of lumbar spinal cord, initial encounter. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 93 codes in category S34 (Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level). The Alphabetic Index lists it under 1 entry. Its 7th character, A, means initial encounter. Its coding notes include a Use additional code instruction, a Code also instruction and 8 Excludes2 entries.

7th character

Category S34 requires a 7th character.

Assembled code S34.124A Open code

Guidelines tips

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

The 7th character depends on whether the patient is in active treatment, not on who sees the patient. An aftercare Z code is not used for injury aftercare.

Guidelines I.C.19.aInjuries: application of 7th charactersRead the official text

Each injury gets its own code unless a combination code exists, with the most serious injury first. Superficial injuries at the same site as a more severe injury are not coded. Injuries during medical care are coded as complications.

Guidelines I.C.19.bCoding of injuriesRead the official text

Use additional code

Add the listed code as a secondary code, if known.

Also from chapter/block level (1 note)
Inherited from Chapter 19 Injury, poisoning and certain other consequences of external causes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code also

Two codes may be needed to describe the condition. This note gives no sequencing order.

Inherited from S34 Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level
  • any associated:
    • fracture of vertebra (S22.0-, S32.0-)
    • open wound of abdomen, lower back and pelvis (S31.-)
    • transient paralysis (R29.5)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (8 notes)
Inherited from S30–S39 Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals
  • burns and corrosions (T20-T32)
  • effects of foreign body in anus and rectum (T18.5)
  • effects of foreign body in genitourinary tract (T19.-)
  • effects of foreign body in stomach, small intestine and colon (T18.2-T18.4)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Inherited from Chapter 19 Injury, poisoning and certain other consequences of external causes
  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Neuro Rehabilitation clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

IRF 60% Rule

On the CMS list of diagnoses used to determine presumptive compliance with the IRF 60 percent rule.

Source: CMS IRF Presumptive Compliance-3, FY 2027 IRF PPS final rule files, effective for discharges on or after October 1, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 377 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

HAC

On the CMS list of hospital-acquired conditions (HAC 05: Falls and Trauma). When the claim reports it with a present-on-admission (POA) indicator of N (not present) or U (documentation insufficient), CMS does not pay the CC or MCC DRG for it. A POA of Y (present) or W (clinically undetermined) is paid normally.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix I; CMS Hospital-Acquired Conditions (HAC) Coding page, POA indicator payment table

Includes

Further defines or gives examples of the content of the category.

Also from chapter/block level (6 notes)
Inherited from S30–S39 Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals
  • injuries to the abdominal wall
  • injuries to the anus
  • injuries to the buttock
  • injuries to the external genitalia
  • injuries to the flank
  • injuries to the groin

Inclusion terms

Conditions classified to this code.

Inherited from S34.124 Incomplete lesion of L4 level of lumbar spinal cord
  • Incomplete lesion of lumbar spinal cord level 4

Notes

Inherited from S34 Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level
  • Code to highest level of lumbar cord injury
  • Injuries to the spinal cord (S34.0 and S34.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given.
Also from chapter/block level (2 notes)
Inherited from Chapter 19 Injury, poisoning and certain other consequences of external causes
  • 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
  • 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.

Alphabetic Index terms

Terms the official Alphabetic Index lists for S34.124. This code adds the 7th character. 1 entry