ICD-10 Coding for Calcaneal Fracture(S92.00xA, S92.01xA, S92.02xA, S92.11xA, M84.57xA)
Complete ICD-10-CM coding and documentation guide for Calcaneal Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Calcaneal Fracture
S92.00-S92.02Primary Range
Fracture of calcaneus
These codes cover fractures of the calcaneus, including unspecified, body of right, and body of left calcaneus.
Pathological fracture in neoplastic disease, ankle/foot
This range is relevant for pathological fractures due to underlying conditions like neoplasms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S92.00xA | Fracture of unspecified calcaneus, initial encounter | Use when the fracture details are not specified in the documentation. |
|
| S92.01xA | Fracture of body of right calcaneus, initial encounter | Use when imaging confirms a fracture of the body of the right calcaneus. |
|
| S92.02xA | Fracture of body of left calcaneus, initial encounter | Use when imaging confirms a fracture of the body of the left calcaneus. |
|
| S92.11xA | Displaced intra-articular fracture of right calcaneus | Use when CT confirms intra-articular involvement with displacement. |
|
| M84.57xA | Pathological fracture in neoplastic disease, ankle/foot | Use when the fracture is due to an underlying neoplastic disease. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for calcaneal fracture
Essential facts and insights about Calcaneal Fracture
Primary ICD-10-CM Codes for calcaneal fracture
Decision Criteria
documentation Criteria
- Lack of specific fracture details in clinical notes
Applicable To
- Unspecified calcaneal fracture
Excludes
- Specific fractures of the calcaneus
Clinical Validation Requirements
- Clinical notes indicating a fracture without specific details on location or type
Code-Specific Risks
- Risk of under-coding due to lack of specificity
Coding Notes
- Avoid using this code when specific details are available.
S92.01xA - Fracture of body of right calcaneus, initial encounter
Use when imaging confirms a fracture of the body of the right calcaneus.
Applicable To
- Fracture of the body of the right calcaneus
Clinical Validation Requirements
- Imaging confirming fracture of the body of the right calcaneus
Coding Notes
Ensure laterality and specific fracture details are documented.
S92.02xA - Fracture of body of left calcaneus, initial encounter
Use when imaging confirms a fracture of the body of the left calcaneus.
Applicable To
- Fracture of the body of the left calcaneus
Clinical Validation Requirements
- Imaging confirming fracture of the body of the left calcaneus
Coding Notes
Ensure laterality and specific fracture details are documented.
S92.11xA - Displaced intra-articular fracture of right calcaneus
Use when CT confirms intra-articular involvement with displacement.
Applicable To
- Displaced intra-articular fracture of the right calcaneus
Clinical Validation Requirements
- CT scan confirming intra-articular involvement with displacement
Coding Notes
Ensure displacement and intra-articular involvement are documented.
M84.57xA - Pathological fracture in neoplastic disease, ankle/foot
Use when the fracture is due to an underlying neoplastic disease.
Applicable To
- Pathological fracture due to neoplastic disease
Clinical Validation Requirements
- Documentation of underlying neoplastic disease
Coding Notes
Ensure underlying neoplastic disease is documented.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Displaced intra-articular fracture of right calcaneus
S92.11xADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Calcaneal Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S92.00xA.
Impact
Clinical: May lead to incorrect treatment planning., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential for denied claims due to incomplete documentation.
Mitigation Strategy
Always document the side of the body affected, Use templates that prompt for laterality
Impact
Reimbursement: May lead to lower reimbursement rates due to lack of specificity., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases the accuracy of healthcare data.
Mitigation Strategy
Ensure documentation includes specific fracture details such as location, laterality, and type.
Impact
Risk of audits due to use of unspecified codes when specific details are available.
Mitigation Strategy
Ensure documentation includes all necessary details for specific coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Calcaneal Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Calcaneal Fracture
Use these documentation templates to ensure complete and accurate documentation for Calcaneal Fracture. These templates include all required elements for proper coding and billing.
Initial assessment of calcaneal fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging findings
- Neurovascular status
- Skin condition
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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