ICD-10 Coding for Femoral Fracture(S72.001A, M84.451A)
Complete ICD-10-CM coding and documentation guide for Femoral Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Femoral Fracture
S72.0-S72.9Primary Range
Fractures of femur
This range covers all types of femoral fractures, including specific locations and types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.001A | Fracture of unspecified part of neck of right femur, initial encounter for closed fracture | Use for initial encounter of closed fracture of the right femoral neck. |
|
| M84.451A | Pathological fracture in neoplastic disease, right femur, initial encounter | Use when the fracture is due to 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 femoral fracture
Essential facts and insights about Femoral Fracture
Primary ICD-10-CM Codes for fractions femur
Decision Criteria
clinical Criteria
- Presence of fracture on imaging
documentation Criteria
- Documentation of closed fracture
Applicable To
- Closed fracture of femoral neck
Excludes
- Open fracture of femoral neck
Clinical Validation Requirements
- X-ray confirmation of fracture
- Clinical documentation of closed fracture
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality and fracture type (open/closed) are documented.
M84.451A - Pathological fracture in neoplastic disease, right femur, initial encounter
Use when the fracture is due to neoplastic disease.
Applicable To
- Fracture due to cancer
Excludes
- Traumatic fracture
Clinical Validation Requirements
- Evidence of neoplastic disease
- Imaging showing pathological fracture
Coding Notes
Ensure underlying condition causing the fracture is documented.
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.
Fracture of unspecified part of neck of left femur, initial encounter for closed fracture
S72.002AFracture of unspecified part of neck of right femur, initial encounter for closed fracture
S72.001ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Femoral Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.001A.
Impact
Clinical: Impacts treatment planning., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential claim denials.
Mitigation Strategy
Always verify and document laterality., Use checklists in EHR systems.
Impact
Reimbursement: Incorrect laterality can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Verify and document the correct side of the fracture.
Impact
Reimbursement: May affect DRG assignment and reimbursement., Compliance: Non-compliance with coding standards., Data Quality: Impacts clinical data accuracy.
Mitigation Strategy
Ensure clear documentation of whether the fracture is open or closed.
Impact
Inadequate documentation of fracture type can lead to audit issues.
Mitigation Strategy
Ensure detailed documentation of fracture characteristics.
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 Femoral Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Femoral Fracture
Use these documentation templates to ensure complete and accurate documentation for Femoral Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for femoral fracture
Specialty: OrthopedicsRequired Elements
- Fracture location
- Fracture type
- Laterality
- Etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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