ICD-10 Coding for Fracture of Pelvis(S32.1XXA, S32.4XXA)
Complete ICD-10-CM coding and documentation guide for Fracture of Pelvis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fracture of Pelvis
S32.0-S32.9Primary Range
Fracture of lumbar spine and pelvis
This range includes specific codes for fractures of different parts of the pelvis, such as the sacrum, ilium, and acetabulum.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S32.1XXA | Fracture of sacrum, initial encounter | Use for initial encounters involving sacral fractures confirmed by imaging. |
|
| S32.4XXA | Fracture of acetabulum, initial encounter | Use for initial encounters involving acetabular fractures confirmed by imaging. |
|
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 pelvis
Essential facts and insights about Fracture of Pelvis
Primary ICD-10-CM Codes for fracture of pelvis
Decision Criteria
clinical Criteria
- Presence of fracture line on imaging
Applicable To
- Fracture of sacral ala
Excludes
- Fracture of coccyx (S32.2XXA)
Clinical Validation Requirements
- CT scan showing fracture line through S1-S2 junction
Code-Specific Risks
- Confusion with coccyx fractures
Coding Notes
- Ensure to specify laterality and encounter type.
S32.4XXA - Fracture of acetabulum, initial encounter
Use for initial encounters involving acetabular fractures confirmed by imaging.
Applicable To
- Fracture of posterior wall of acetabulum
Excludes
- Fracture of femoral head (S72.0XXA)
Clinical Validation Requirements
- Judet views demonstrating posterior wall involvement
Coding Notes
Document fracture pattern and displacement.
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 Fracture of Pelvis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S32.1XXA.
Impact
Clinical: Impacts treatment decisions and follow-up care., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential for denied claims due to incomplete documentation.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data recording.
Mitigation Strategy
Use CPT 27197/27198 for posterior fractures and E/M codes for anterior.
Impact
Inadequate documentation of fracture pattern can lead to audit issues.
Mitigation Strategy
Ensure detailed imaging reports and clinical notes are included in the patient record.
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 Pelvis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture of Pelvis
Use these documentation templates to ensure complete and accurate documentation for Fracture of Pelvis. These templates include all required elements for proper coding and billing.
Initial encounter for pelvic fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Fracture location and type
- Imaging findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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