ICD-10 Coding for Left Clavicle Fracture(S42.012A, S42.022A)
Complete ICD-10-CM coding and documentation guide for Left Clavicle Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Clavicle Fracture
S42.0-S42.09Primary 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 |
|---|---|---|---|
| S42.012A | Anterior displaced fracture of sternal end of left clavicle, initial encounter for closed fracture | Use for initial encounter when anterior displacement of the sternal end is confirmed. |
|
| S42.022A | Displaced fracture of shaft of left clavicle, initial encounter for closed fracture | Use for initial encounter when a displaced shaft fracture 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 left clavicle fracture
Essential facts and insights about Left Clavicle Fracture
Primary ICD-10-CM Codes for left clavicle fracture
Decision Criteria
clinical Criteria
- Anterior displacement confirmed by imaging
Applicable To
- Anterior displacement of sternal end fracture
Excludes
- Fracture of scapula (S42.1-)
Clinical Validation Requirements
- CT scan confirming anterior displacement
- Closed fracture from motor vehicle collision
Code-Specific Risks
- Ensure displacement is documented; otherwise, use nondisplaced code.
Coding Notes
- Ensure to document the displacement and encounter type clearly.
S42.022A - Displaced fracture of shaft of left clavicle, initial encounter for closed fracture
Use for initial encounter when a displaced shaft fracture is confirmed.
Applicable To
- Displaced midshaft fracture
Excludes
- Fracture of scapula (S42.1-)
Clinical Validation Requirements
- X-ray showing comminuted midshaft fracture with 2cm shortening
Coding Notes
Document the displacement and encounter type clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Clavicle Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.012A.
Impact
Clinical: Can lead to incorrect treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to incomplete documentation.
Mitigation Strategy
Always include 'left' or 'right' in the documentation., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect 7th character can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data for patient care and research.
Mitigation Strategy
Ensure to use the correct 7th character to indicate the encounter type.
Impact
Audits may flag records with insufficient fracture details.
Mitigation Strategy
Ensure all documentation includes specific fracture details such as location, displacement, and encounter type.
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 Left Clavicle Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Clavicle Fracture
Use these documentation templates to ensure complete and accurate documentation for Left Clavicle Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for displaced shaft fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging findings
- Neurovascular status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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