ICD-10 Coding for Fracture of Left Hip(S72.002A, M84.452A, M97.02XA)
Complete ICD-10-CM coding and documentation guide for Fracture of Left Hip. 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 Hip
S72.0-S72.2Primary Range
Fractures of femur
These codes cover various types of femoral fractures, including neck, intertrochanteric, and subtrochanteric fractures.
Pathological fracture
Used for fractures due to underlying conditions like osteoporosis or metastasis.
Periprosthetic fracture around internal prosthetic joint
Used when the fracture occurs around a prosthetic joint.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.002A | Unspecified fracture of neck of left femur, initial encounter for closed fracture | Use for traumatic fractures of the femoral neck when the specific type is not documented. |
|
| M84.452A | Pathological fracture in neoplastic disease, left femur | Use when the fracture is due to an underlying condition like cancer. |
|
| M97.02XA | Periprosthetic fracture around internal prosthetic joint, left hip, initial encounter | Use when a fracture occurs around a prosthetic joint. |
|
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 fracture of left hip
Essential facts and insights about Fracture of Left Hip
Primary ICD-10-CM Codes for fracture of left hip
Decision Criteria
clinical Criteria
- Confirmed traumatic fracture via imaging
documentation Criteria
- Includes laterality and encounter type
Applicable To
- Traumatic fracture of femoral neck
Excludes
- Pathological fracture (M84.4)
Clinical Validation Requirements
- X-ray or MRI confirming femoral neck fracture
- History of trauma or fall
Code-Specific Risks
- Ensure laterality is documented
- Differentiate from pathological fractures
Coding Notes
- Ensure documentation specifies the type of fracture and encounter type.
M84.452A - Pathological fracture in neoplastic disease, left femur
Use when the fracture is due to an underlying condition like cancer.
Applicable To
- Fracture due to cancer metastasis
Excludes
- Traumatic fracture (S72.0-S72.2)
Clinical Validation Requirements
- Imaging showing fracture without trauma
- Evidence of underlying neoplastic disease
Coding Notes
Document the underlying condition causing the fracture.
M97.02XA - Periprosthetic fracture around internal prosthetic joint, left hip, initial encounter
Use when a fracture occurs around a prosthetic joint.
Applicable To
- Fracture around hip prosthesis
Excludes
- Fracture of prosthesis (T84.0)
Clinical Validation Requirements
- Imaging showing fracture around prosthetic joint
- History of hip arthroplasty
Coding Notes
Ensure documentation specifies the relationship to the prosthesis.
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
W00.0XXADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pathological fracture in neoplastic disease, left femur
M84.452AUnspecified fracture of neck of left femur, initial encounter for closed fracture
S72.002AMechanical complication of internal joint prosthesis, initial encounter
T84.02XADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fracture of Left Hip to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.002A.
Impact
Clinical: Incomplete injury documentation, Regulatory: Non-compliance with coding guidelines, Financial: Potential for denied claims
Mitigation Strategy
Always include external cause codes for traumatic fractures, Review coding guidelines for injury documentation
Impact
Reimbursement: Incorrect coding may lead to denied claims or incorrect reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Clarify the etiology of the fracture in the documentation.
Impact
Reimbursement: Claims may be denied due to lack of specificity., Compliance: Non-compliance with ICD-10 requirements for laterality., Data Quality: Incomplete patient records.
Mitigation Strategy
Ensure documentation specifies 'left' or 'right' for all hip fractures.
Impact
Failure to sequence periprosthetic fracture codes correctly can lead to audit flags.
Mitigation Strategy
Train staff on proper sequencing rules and review claims for compliance.
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 Hip, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture of Left Hip
Use these documentation templates to ensure complete and accurate documentation for Fracture of Left Hip. These templates include all required elements for proper coding and billing.
Acute Traumatic Left Hip Fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging results
- Type and location of fracture
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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