ICD-10 Coding for Radial Head Fracture(S52.121A, S52.122A)
Complete ICD-10-CM coding and documentation guide for Radial Head Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Radial Head Fracture
S52.1-Primary Range
Fracture of the head of the radius
This range includes all fractures of the radial head, specifying laterality and encounter type.
External causes of falls
These codes are used to specify the external cause of injury, such as falls, which are common mechanisms for radial head fractures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S52.121A | Displaced fracture of head of right radius, initial encounter | Use for initial treatment of a displaced fracture of the right radial head. |
|
| S52.122A | Displaced fracture of head of left radius, initial encounter | Use for initial treatment of a displaced fracture of the left radial head. |
|
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 radial head fracture
Essential facts and insights about Radial Head Fracture
Primary ICD-10-CM Codes for radial head fracture
Decision Criteria
clinical Criteria
- Presence of a displaced fracture confirmed by imaging
documentation Criteria
- Documentation of initial encounter and mechanism of injury
Applicable To
- Displaced fracture of right radial head
Excludes
- Fracture of neck of radius (S52.13-)
Clinical Validation Requirements
- X-ray showing ≥2mm displacement
- Documentation of initial encounter
Code-Specific Risks
- Missing laterality
- Incorrect encounter type
Coding Notes
- Ensure documentation specifies laterality and encounter type.
S52.122A - Displaced fracture of head of left radius, initial encounter
Use for initial treatment of a displaced fracture of the left radial head.
Applicable To
- Displaced fracture of left radial head
Excludes
- Fracture of neck of radius (S52.13-)
Clinical Validation Requirements
- X-ray showing ≥2mm displacement
- Documentation of initial encounter
Coding Notes
Ensure documentation specifies laterality 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, initial encounter
W00.0XXADifferential 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 Radial Head Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S52.121A.
Impact
Clinical: Incomplete clinical picture for treatment planning., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims due to incomplete documentation.
Mitigation Strategy
Always document how the injury occurred., Use external cause codes to specify the mechanism.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding standards., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Always specify right or left in the documentation.
Impact
Reimbursement: May affect the reimbursement rate., Compliance: Leads to coding errors and potential audits., Data Quality: Impacts the accuracy of patient records.
Mitigation Strategy
Ensure the correct 7th character is used for the encounter type.
Impact
Using the wrong 7th character for encounter type.
Mitigation Strategy
Regular training on encounter coding and review of documentation.
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 Radial Head Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Radial Head Fracture
Use these documentation templates to ensure complete and accurate documentation for Radial Head Fracture. These templates include all required elements for proper coding and billing.
Initial Evaluation of Radial Head Fracture
Specialty: OrthopedicsRequired Elements
- Patient history
- Mechanism of injury
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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