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ICD-10 Coding for Collar Bone Fracture(S42.001A, S42.021A)

Complete ICD-10-CM coding and documentation guide for Collar Bone Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Clavicle FractureBroken Collarbone

Related ICD-10 Code Ranges

Complete code families applicable to Collar Bone Fracture

S42.0Primary Range

Fracture of clavicle

This range includes all types of clavicle fractures, specifying location, laterality, and displacement.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
S42.001AFracture of unspecified part of right clavicle, initial encounter for closed fractureUse when the specific part of the clavicle is not documented.
  • X-ray confirmation of clavicle fracture
  • Documentation of laterality
S42.021ADisplaced fracture of shaft of right clavicle, initial encounter for closed fractureUse when the fracture is displaced and located at the shaft.
  • X-ray showing displacement
  • Documentation of shaft location

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 collar bone fracture

Essential facts and insights about Collar Bone Fracture

The ICD-10 code for a collar bone fracture varies based on specifics like location and displacement. Key codes include S42.001A and S42.021A.

Primary ICD-10-CM Codes for collar bone fracture

Fracture of unspecified part of right clavicle, initial encounter for closed fracture
Billable Code

Decision Criteria

documentation Criteria

  • Laterality and fracture type must be specified.

Applicable To

  • Unspecified part of clavicle fracture

Excludes

Clinical Validation Requirements

  • X-ray confirmation of clavicle fracture
  • Documentation of laterality

Code-Specific Risks

  • Lack of specificity may lead to incorrect coding.

Coding Notes

  • Ensure documentation specifies laterality and fracture type.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Encounter for other orthopedic aftercare

Z47.89
Use for follow-up care after the fracture has healed.

Periprosthetic fracture around internal fixation device of right clavicle

M97.11XK
Use when a fracture occurs around a fixation device.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Displaced fracture of shaft of right clavicle, initial encounter for closed fracture

S42.021A
Use when the fracture is specifically identified as displaced and located at the shaft.

Nonunion of fracture of lateral end of right clavicle

S42.031K
Use for nonunion cases confirmed by imaging.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Collar Bone Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.001A.

Impact

Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.

Mitigation Strategy

Always document laterality in clinical notes.

Impact

Reimbursement: May lead to claim denials or reduced payments., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for clinical and research purposes.

Mitigation Strategy

Ensure documentation specifies the exact part of the clavicle.

Impact

Risk of audits due to non-specific coding.

Mitigation Strategy

Ensure detailed documentation of fracture specifics.

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 Collar Bone Fracture, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Collar Bone Fracture

Use these documentation templates to ensure complete and accurate documentation for Collar Bone Fracture. These templates include all required elements for proper coding and billing.

Initial encounter for displaced clavicle fracture

Specialty: Orthopedics

Required Elements

  • Patient history
  • Physical examination
  • Imaging results
  • Assessment and plan

Example Documentation

35M presents after fall with right shoulder pain. X-ray shows displaced fracture of shaft of right clavicle. Plan: immobilization and orthopedic follow-up.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Right clavicle fracture.
Good Documentation Example
Displaced fracture of shaft of right clavicle, initial encounter. Plan: immobilization.
Explanation
The good example provides specific location and encounter details.

Need help with ICD-10 coding for Collar Bone Fracture? Ask your questions below.

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