2025 ICD-10-CM code S30.0XXA
Contusion of lower back and pelvis, initial encounter.
Medical necessity for the evaluation and management of a contusion of the lower back and pelvis is based on the severity of the injury, the presence of associated symptoms, and the potential for complications.
Contusion of the lower back and pelvis can result in pain and tenderness at the injury site, redness and swelling, numbness, bluish discoloration of the skin, hematoma sometimes, and damage to internal organs in case of severe injury. Providers diagnose the condition based on the patient’s history and physical examination. Treatment options include medications such as analgesics, application of ice, and rest.
In simple words: A bruise in the lower back and pelvis area, caused by a blunt injury like a fall or accident, where the small blood vessels leak but don't tear. This code is used for the first doctor's visit for this injury.
Contusion, also known as a bruise, of the lower back and pelvis refers to blood accumulation in the lower back and pelvis as a result of blunt trauma such as a fall, motor vehicle accident, or sports activity, that causes the capillaries, the smallest blood vessels, to leak but does not result in a tear or laceration. This code applies to the initial encounter for the injury.
Example 1: A patient falls from a ladder and presents with pain and bruising in the lower back and pelvic area. The physician diagnoses a contusion of the lower back and pelvis., A football player is tackled and experiences blunt trauma to the lower back and pelvis. Examination reveals a contusion, with localized pain and swelling., A car accident victim sustains injuries including a contusion of the lower back and pelvis. There is significant bruising and tenderness in the affected region.
Documentation should include details of the injury, including the mechanism of trauma, location and extent of the contusion, associated symptoms (pain, swelling, discoloration), and any diagnostic tests performed.
- Specialties:Emergency Medicine, Family Medicine, Orthopedics, Sports Medicine, Trauma Surgery
- Place of Service:Office, Home, Inpatient Hospital, On Campus-Outpatient Hospital, Emergency Room - Hospital,Independent Clinic, Federally Qualified Health Center, Public Health Clinic, Rural Health Clinic