ICD-10 Coding for Clavicle Fracture(S42.021A, S42.001A)
Complete ICD-10-CM coding and documentation guide for Clavicle Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Clavicle Fracture
S42.00-S42.09Primary Range
Fracture of clavicle
This range includes all types of clavicle fractures, specifying location and displacement.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S42.021A | Displaced fracture of shaft of right clavicle, initial encounter | Use when imaging confirms a displaced fracture of the right clavicle shaft. |
|
| S42.001A | Fracture of unspecified part of clavicle, initial encounter | Use only when specific location and displacement cannot be determined. |
|
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 displaced clavicle fracture
Essential facts and insights about Clavicle Fracture
Primary ICD-10-CM Codes for clavicle fracture
Decision Criteria
clinical Criteria
- Imaging confirms displacement of the clavicle shaft.
documentation Criteria
- Documentation must specify 'displaced' and 'shaft'.
Applicable To
- Displaced midshaft fracture of right clavicle
Clinical Validation Requirements
- X-ray or CT confirming displacement and location
Code-Specific Risks
- Misclassification as non-displaced if imaging is unclear
Coding Notes
- Ensure documentation specifies displacement and location.
S42.001A - Fracture of unspecified part of clavicle, initial encounter
Use only when specific location and displacement cannot be determined.
Excludes
- Specific location fractures (S42.021-S42.029)
Clinical Validation Requirements
- Lack of specific imaging or documentation
Coding Notes
Avoid use if specific location can be determined.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified fall, initial encounter
W19.XXXADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Clavicle Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.021A.
Impact
Clinical: May affect treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure imaging reports are reviewed and documented., Use checklists for documentation in fracture cases.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available based on imaging and documentation.
Impact
Risk of using unspecified codes when specific details are available.
Mitigation Strategy
Train staff on the importance of detailed documentation and 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 Clavicle Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Clavicle Fracture
Use these documentation templates to ensure complete and accurate documentation for Clavicle Fracture. These templates include all required elements for proper coding and billing.
Initial ED Visit for Clavicle Fracture
Specialty: Emergency MedicineRequired Elements
- Mechanism of injury
- Location and displacement of fracture
- Neurovascular status
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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