ICD-10 Coding for Scaphoid Fracture(S62.001, S62.032B)
Complete ICD-10-CM coding and documentation guide for Scaphoid Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Scaphoid Fracture
S62.0-Primary Range
Fracture of the scaphoid bone
This range includes all scaphoid fractures, specifying laterality, location, and displacement.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S62.001 | Fracture of unspecified part of scaphoid bone, right wrist | Use when the specific part of the scaphoid is not documented. |
|
| S62.032B | Displaced fracture of proximal third of scaphoid bone, left wrist, initial encounter | Use when imaging confirms a displaced fracture of the proximal third of the scaphoid. |
|
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 scaphoid fracture
Essential facts and insights about Scaphoid Fracture
Primary ICD-10-CM Codes for scaphoid fracture
Decision Criteria
clinical Criteria
- Presence of fracture on imaging
documentation Criteria
- Lack of specific scaphoid part documentation
Applicable To
- Unspecified scaphoid fracture
Excludes
- Other carpal bone fractures
Clinical Validation Requirements
- Confirmed fracture via imaging
- Clinical signs such as snuffbox tenderness
Code-Specific Risks
- Risk of undercoding if specific part is known but not documented
Coding Notes
- Ensure laterality and encounter type are documented.
S62.032B - Displaced fracture of proximal third of scaphoid bone, left wrist, initial encounter
Use when imaging confirms a displaced fracture of the proximal third of the scaphoid.
Applicable To
- Displaced proximal scaphoid fracture
Excludes
- Non-displaced fractures
Clinical Validation Requirements
- Imaging confirming displacement
- Clinical documentation of proximal third involvement
Coding Notes
Ensure displacement and specific location are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified fall, initial encounter
W19.xxxADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Fracture of other carpal bones
S62.1-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Scaphoid Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S62.001.
Impact
Clinical: May affect treatment decisions., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential for denied claims.
Mitigation Strategy
Always document right or left for wrist injuries., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Document and code the specific part of the scaphoid involved.
Impact
Risk of audits due to lack of specificity in fracture coding.
Mitigation Strategy
Ensure all documentation includes specific fracture details 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 Scaphoid Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Scaphoid Fracture
Use these documentation templates to ensure complete and accurate documentation for Scaphoid Fracture. These templates include all required elements for proper coding and billing.
Initial ER Visit for Scaphoid Fracture
Specialty: Emergency MedicineRequired Elements
- Patient demographics
- Mechanism of injury
- Physical exam findings
- Imaging results
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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