ICD-10 Coding for Fracture of Left Elbow(S42.402A)
Complete ICD-10-CM coding and documentation guide for Fracture of Left Elbow. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fracture of Left Elbow
S42.4Primary Range
Fracture of lower end of humerus
This range includes specific codes for fractures of the lower end of the humerus, including laterality and encounter type.
Key Information: ICD-10 code for left elbow fracture
Essential facts and insights about Fracture of Left Elbow
Primary ICD-10-CM Code for fracture of left elbow
Decision Criteria
clinical Criteria
- Presence of a displaced fracture confirmed by imaging
Applicable To
- Displaced fracture of left humeral epicondyle
Excludes
- Fracture of unspecified part of humerus
Clinical Validation Requirements
- X-ray or CT confirming displacement
- Clinical documentation of fracture type and laterality
Code-Specific Risks
- Omission of laterality or encounter type
Coding Notes
- Ensure documentation includes laterality, fracture type, and encounter type.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fall on same level from slipping, tripping and stumbling without subsequent striking against object
W00.0xxADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Non-displaced fracture of left ulna, initial encounter
S52.022ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fracture of Left Elbow to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.402A.
Impact
Clinical: Leads to inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always specify laterality and encounter type., Use coding templates.
Impact
Reimbursement: Incorrect coding can lead to claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies left side and encounter type (initial, subsequent, sequela).
Impact
Failure to document laterality and encounter type.
Mitigation Strategy
Use standardized templates and checklists.
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 Fracture of Left Elbow, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture of Left Elbow
Use these documentation templates to ensure complete and accurate documentation for Fracture of Left Elbow. These templates include all required elements for proper coding and billing.
Initial encounter for displaced fracture of left humeral epicondyle
Specialty: OrthopedicsRequired Elements
- Fracture type
- Laterality
- Encounter type
- External cause
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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