ICD-10 Coding for Right Clavicle Fracture(S42.001A, S42.021A)
Complete ICD-10-CM coding and documentation guide for Right Clavicle Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Clavicle Fracture
S42.00-S42.09Primary Range
Fracture of clavicle
This range includes all types of clavicle fractures, specifying the location and displacement status.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S42.001A | Fracture of unspecified part of right clavicle, initial encounter for closed fracture | Use when the fracture location on the right clavicle is not specified in the documentation. |
|
| S42.021A | Displaced fracture of shaft of right clavicle, initial encounter for closed fracture | Use when the fracture is documented as displaced and located at the shaft of the right clavicle. |
|
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 clavicle fracture
Essential facts and insights about Right Clavicle Fracture
Primary ICD-10-CM Codes for right clavicle fracture
Decision Criteria
documentation Criteria
- Documentation lacks specific location details of the fracture.
Applicable To
- Unspecified right clavicle fracture
Excludes
- Open fracture of right clavicle
Clinical Validation Requirements
- Clinical examination showing pain and swelling in the right clavicle area
- X-ray confirming fracture without specific location details
Code-Specific Risks
- Risk of under-coding if specific location is documented but not coded
Coding Notes
- Ensure documentation specifies the fracture location and displacement status to avoid using unspecified codes.
S42.021A - Displaced fracture of shaft of right clavicle, initial encounter for closed fracture
Use when the fracture is documented as displaced and located at the shaft of the right clavicle.
Applicable To
- Displaced midshaft fracture of right clavicle
Excludes
- Nondisplaced fracture of shaft of right clavicle
Clinical Validation Requirements
- X-ray showing displacement of the shaft of the right clavicle
- Clinical documentation specifying displacement
Coding Notes
Ensure displacement is clearly documented to justify the use of this code.
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.
Displaced fracture of shaft of right clavicle, initial encounter for closed fracture
S42.021AFracture of unspecified part of right clavicle, initial encounter for closed fracture
S42.001ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Clavicle Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.001A.
Impact
Clinical: May lead to inappropriate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure imaging reports are reviewed and documented., Train staff on importance of detailed documentation.
Impact
Reimbursement: May lead to lower reimbursement rates due to lack of specificity., Compliance: Increases risk of non-compliance with coding guidelines., Data Quality: Reduces the quality and accuracy of healthcare data.
Mitigation Strategy
Ensure documentation specifies the fracture location and displacement status.
Impact
High risk of audit if unspecified codes are used when specific details are available.
Mitigation Strategy
Ensure all documentation includes specific fracture details.
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 Clavicle Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Clavicle Fracture
Use these documentation templates to ensure complete and accurate documentation for Right Clavicle Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for right clavicle fracture
Specialty: OrthopedicsRequired Elements
- Chief complaint
- History of present illness
- Physical examination
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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