ICD-10 Coding for Collarbone Fracture(S42.021A, S42.021K)
Complete ICD-10-CM coding and documentation guide for Collarbone Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Collarbone Fracture
S42.0Primary Range
Fracture of clavicle
This range includes all types of clavicle fractures, specifying laterality, displacement, and encounter type.
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 for initial encounter of a displaced fracture of the right clavicle shaft. |
|
| S42.021K | Displaced fracture of shaft of right clavicle, subsequent encounter for nonunion | Use for subsequent encounters where nonunion is confirmed. |
|
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 collarbone fracture
Essential facts and insights about Collarbone Fracture
Primary ICD-10-CM Codes for collarbone fracture
Decision Criteria
clinical Criteria
- Presence of fracture confirmed by imaging
documentation Criteria
- Documentation of displacement and laterality
Applicable To
- Displaced fracture of right clavicle shaft
Excludes
- Pathological fracture of clavicle (M84.52-)
Clinical Validation Requirements
- X-ray confirmation of displaced fracture
- Clinical examination showing swelling and tenderness
Code-Specific Risks
- Assuming displacement without documentation
Coding Notes
- Ensure documentation specifies laterality and displacement.
S42.021K - Displaced fracture of shaft of right clavicle, subsequent encounter for nonunion
Use for subsequent encounters where nonunion is confirmed.
Applicable To
- Nonunion of displaced fracture of right clavicle shaft
Excludes
- Pathological fracture of clavicle (M84.52-)
Clinical Validation Requirements
- X-ray showing nonunion
- Persistent pain and lack of healing
Coding Notes
Ensure documentation specifies nonunion status.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Collarbone 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: Potential for incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Denied claims due to incomplete documentation.
Mitigation Strategy
Always document right or left for clavicle fractures.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Always verify and document whether the fracture is open or closed.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure all documentation specifies fracture details.
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 Collarbone Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Collarbone Fracture
Use these documentation templates to ensure complete and accurate documentation for Collarbone Fracture. These templates include all required elements for proper coding and billing.
Initial Encounter for Clavicle Fracture
Specialty: Emergency MedicineRequired Elements
- Patient demographics
- Mechanism of injury
- Physical examination findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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