ICD-10 Coding for Right Arm Fracture(S42.3XXA, S52.5XXA)
Complete ICD-10-CM coding and documentation guide for Right Arm Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Arm Fracture
S42-S52Primary Range
Fractures of shoulder and upper arm, forearm
This range includes all relevant codes for fractures of the right arm, including humerus, radius, and ulna.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S42.3XXA | Fracture of shaft of humerus, right arm, initial encounter | Use for initial encounters of humeral shaft fractures in the right arm. |
|
| S52.5XXA | Fracture of lower end of radius, right arm, initial encounter | Use for initial encounters of distal radius fractures in the right arm. |
|
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 right arm fracture
Essential facts and insights about Right Arm Fracture
Primary ICD-10-CM Codes for right arm fracture
Decision Criteria
clinical Criteria
- Presence of fracture on imaging
documentation Criteria
- Detailed description of fracture type and encounter
Applicable To
- Displaced fracture of humerus shaft
- Nondisplaced fracture of humerus shaft
Excludes
- Fracture of humerus, unspecified part
Clinical Validation Requirements
- X-ray confirmation of fracture
- Physical exam findings of swelling or deformity
Code-Specific Risks
- Incorrect laterality
- Missing encounter type
Coding Notes
- Ensure documentation specifies open vs closed and displaced vs nondisplaced.
S52.5XXA - Fracture of lower end of radius, right arm, initial encounter
Use for initial encounters of distal radius fractures in the right arm.
Applicable To
- Colles' fracture
- Smith's fracture
Excludes
- Fracture of radius, unspecified part
Clinical Validation Requirements
- X-ray showing fracture at distal radius
- Clinical signs of wrist deformity
Coding Notes
Document specific fracture type and treatment method.
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 Right Arm Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.3XXA.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific anatomical terms, Include imaging and clinical findings
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Non-compliance with coding standards., Data Quality: Decreases accuracy of medical records.
Mitigation Strategy
Always specify the exact bone and fracture type.
Impact
Missing details on fracture type and treatment.
Mitigation Strategy
Implement thorough documentation templates.
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 Right Arm Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Arm Fracture
Use these documentation templates to ensure complete and accurate documentation for Right Arm Fracture. These templates include all required elements for proper coding and billing.
Closed reduction of right radial shaft fracture
Specialty: OrthopedicsRequired Elements
- Patient demographics
- Mechanism of injury
- Imaging findings
- Neurovascular status
- Treatment method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Right Arm Fracture? Ask your questions below.