ICD-10 Coding for Right Hip Surgery(M16.11, M87.051, S72.001D)
Complete ICD-10-CM coding and documentation guide for Right Hip Surgery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Hip Surgery
M16.0-M16.9Primary Range
Osteoarthritis of hip
Primary range for coding osteoarthritis leading to hip replacement.
Avascular necrosis of bone
Relevant for cases where avascular necrosis is the reason for hip surgery.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M16.11 | Unilateral primary osteoarthritis, right hip | Use when primary osteoarthritis is the reason for surgery. |
|
| M87.051 | Idiopathic aseptic necrosis of right femur | Use when avascular necrosis is idiopathic and affects the right hip. |
|
| S72.001D | Fracture of unspecified part of neck of right femur, subsequent encounter | Use for follow-up visits after initial fracture treatment. |
|
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 hip surgery
Essential facts and insights about Right Hip Surgery
Primary ICD-10-CM Codes for right hip surgery
Decision Criteria
clinical Criteria
- Patient exhibits symptoms consistent with primary osteoarthritis.
Applicable To
- Primary osteoarthritis of right hip
Excludes
- Secondary osteoarthritis of right hip (M16.51)
Clinical Validation Requirements
- Radiographic evidence of joint space narrowing
- Patient history of pain and limited mobility
Code-Specific Risks
- Incorrectly coding unspecified osteoarthritis
Coding Notes
- Ensure documentation supports primary osteoarthritis diagnosis.
M87.051 - Idiopathic aseptic necrosis of right femur
Use when avascular necrosis is idiopathic and affects the right hip.
Applicable To
- Idiopathic avascular necrosis of right hip
Excludes
- Avascular necrosis due to trauma (M87.151)
Clinical Validation Requirements
- MRI showing subchondral collapse
- Patient history of steroid use or alcohol abuse
Coding Notes
Document MRI findings and patient history thoroughly.
S72.001D - Fracture of unspecified part of neck of right femur, subsequent encounter
Use for follow-up visits after initial fracture treatment.
Applicable To
- Subsequent encounter for fracture treatment
Excludes
- Initial encounter for fracture (S72.001A)
Clinical Validation Requirements
- Radiographic evidence of fracture
- Documentation of fracture treatment plan
Coding Notes
Ensure correct sequencing with fracture codes.
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.
Unilateral post-traumatic osteoarthritis, right hip
M16.51Aseptic necrosis of bone due to drugs, right femur
M87.151Fracture of unspecified part of neck of right femur, initial encounter
S72.001ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Hip Surgery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M16.11.
Impact
Clinical: Leads to potential treatment errors., Regulatory: Non-compliance with documentation standards., Financial: Denial of claims due to lack of specificity.
Mitigation Strategy
Always specify 'right' or 'left' in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure the correct character is used for the encounter type.
Impact
Reimbursement: Incorrect sequencing affects claim approval., Compliance: Violates coding guidelines for fracture aftercare., Data Quality: Misrepresents patient care sequence.
Mitigation Strategy
Code the fracture first, then use Z96.641 for post-surgical status.
Impact
Lack of specific component details in operative notes.
Mitigation Strategy
Use standardized templates that require component 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 Hip Surgery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Hip Surgery
Use these documentation templates to ensure complete and accurate documentation for Right Hip Surgery. These templates include all required elements for proper coding and billing.
Total Hip Arthroplasty
Specialty: Orthopedic SurgeryRequired Elements
- Pre-operative diagnosis
- Post-operative diagnosis
- Procedure details
- Component specifications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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