ICD-10 Coding for Stress Fracture of Right Foot(M84.374A)
Complete ICD-10-CM coding and documentation guide for Stress Fracture of Right Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stress Fracture of Right Foot
M84.3Primary Range
Stress fracture, not elsewhere classified
This range includes stress fractures of bones due to repetitive stress or overuse, such as those in the foot.
Osteoporosis with current pathological fracture
Used when stress fractures occur in the context of osteoporosis.
Key Information: ICD-10 code for stress fracture right foot
Essential facts and insights about Stress Fracture of Right Foot
Primary ICD-10-CM Code for stress fracture right foot
Decision Criteria
clinical Criteria
- MRI shows stress fracture without acute trauma history.
documentation Criteria
- Patient reports pain after repetitive activity, such as running.
Applicable To
- Initial encounter for stress fracture of right foot
Clinical Validation Requirements
- MRI confirmation of stress fracture
- Patient history of repetitive activity or overuse
Code-Specific Risks
- Incorrect use for traumatic fractures
- Omission of 7th character
Coding Notes
- Ensure documentation specifies 'stress fracture' and the specific bone affected.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of stress fracture
Z87.312Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Fracture of metatarsal bone, right foot, initial encounter for closed fracture
S92.301ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stress Fracture of Right Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M84.374A.
Impact
Clinical: Mismanagement of treatment plans., Regulatory: Potential for audit failures., Financial: Denied claims and reimbursement delays.
Mitigation Strategy
Ensure detailed documentation of fracture type and cause.
Impact
Reimbursement: Claims may be denied if incorrect codes are used., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data and statistics.
Mitigation Strategy
Ensure documentation specifies 'stress fracture' and lacks acute trauma.
Impact
Using S-codes for stress fractures can lead to audits.
Mitigation Strategy
Ensure documentation supports stress fracture coding.
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 Stress Fracture of Right Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stress Fracture of Right Foot
Use these documentation templates to ensure complete and accurate documentation for Stress Fracture of Right Foot. These templates include all required elements for proper coding and billing.
Initial encounter for stress fracture in a runner
Specialty: PodiatryRequired Elements
- Location: Right foot, specific bone
- Mechanism: Overuse or repetitive activity
- Symptoms: Gradual onset pain
- Imaging: MRI findings
- Phase: Initial treatment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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