S33.0XXA: Traumatic rupture of lumbar intervertebral disc, initial encounter
S33.0XXA, traumatic rupture of lumbar intervertebral disc, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 13 HCPCS Level II codes, including A9585 (Injection, gadobutrol, 0.1 ml), Q9953 (Injection, iron-based magnetic resonance contrast agent…), G0151 (Services performed by a qualified physical therapist in…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with S33.0XXA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G2251 | Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion | Carrier judgment | — | 1 |
| G0157 | Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0159 | Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2168 | Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| L1972 | Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf | Carrier judgment | — | 1 |
Medicare policy articles listing S33.0XXA
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
- A53058: Billing and Coding: Home Health Physical Therapy (Palmetto GBA (HHH MAC); 6 Level II codes). LCD with the same title: L34564
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other S33 diagnoses (Dislocation and sprain of joints and ligaments of lumbar spine and pelvis)
- S33.110A — Subluxation of L1/L2 lumbar vertebra, initial encounter
- S33.111A — Dislocation of L1/L2 lumbar vertebra, initial encounter
- S33.120A — Subluxation of L2/L3 lumbar vertebra, initial encounter
- S33.121A — Dislocation of L2/L3 lumbar vertebra, initial encounter
- S33.130A — Subluxation of L3/L4 lumbar vertebra, initial encounter
- S33.131A — Dislocation of L3/L4 lumbar vertebra, initial encounter
- S33.140A — Subluxation of L4/L5 lumbar vertebra, initial encounter
- S33.141A — Dislocation of L4/L5 lumbar vertebra, initial encounter
- S33.2XXA — Dislocation of sacroiliac and sacrococcygeal joint, initial encounter
- S33.5XXA — Sprain of ligaments of lumbar spine, initial encounter
- S33.6XXA — Sprain of sacroiliac joint, initial encounter
- S33.8XXA — Sprain of other parts of lumbar spine and pelvis, initial encounter
Frequently asked questions
Does Medicare cover S33.0XXA (Traumatic rupture of lumbar intervertebral disc, initial…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S33.0XXA as a covered diagnosis for 13 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 S33.0XXA?
The Level II codes from the policies most specific to this diagnosis are A9585 (Injection, gadobutrol, 0.1 ml, 1 article); Q9953 (Injection, iron-based magnetic resonance contrast agent…, 1 article); G0151 (Services performed by a qualified physical therapist in…, 2 articles); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 2 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list S33.0XXA?
A57206 (Billing and Coding: Lumbar MRI); A57311 (Billing and Coding: Physical Therapy - Home Health); A53058 (Billing and Coding: Home Health Physical Therapy).
What is ICD-10-CM code S33.0XXA?
S33.0XXA is the ICD-10-CM code for traumatic rupture of lumbar intervertebral disc, initial encounter, in category S33 (Dislocation and sprain of joints and ligaments of lumbar spine and pelvis), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under A9585
- Watch A9585 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9585
Compiled by Caduvo from public CMS (Medicare) records, ICD-10-CM FY2026, HCPCS release October 2026, 2026 fee schedule (non-rural state fees). Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup