ICD-10 Coding for Toe Injury(S90.1, S90.2, S92.4)
Complete ICD-10-CM coding and documentation guide for Toe Injury. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Toe Injury
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S90.1 | Contusion of toe without damage to nail | Use when there is a bruise on the toe without nail damage. |
|
| S90.2 | Contusion of toe with damage to nail | Use when there is a bruise on the toe with nail damage. |
|
| S92.4 | Fracture of toe | Use when there is a confirmed fracture of the toe. |
|
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 toe injury
Essential facts and insights about Toe Injury
Primary ICD-10-CM Codes for toe injury
Decision Criteria
clinical Criteria
- Presence of toe bruise without nail involvement
Applicable To
- Bruise of toe
Excludes
- Fracture of toe (S92.4)
Clinical Validation Requirements
- Physical exam findings of ecchymosis or swelling
Code-Specific Risks
- Ensure laterality is specified to avoid unspecified coding.
Coding Notes
- Ensure to document the absence of nail damage.
S90.2 - Contusion of toe with damage to nail
Use when there is a bruise on the toe with nail damage.
Applicable To
- Subungual hematoma
Excludes
- Fracture of toe (S92.4)
Clinical Validation Requirements
- Documentation of nail bed injury or subungual hematoma
Coding Notes
Document the extent of nail damage clearly.
S92.4 - Fracture of toe
Use when there is a confirmed fracture of the toe.
Applicable To
- Broken toe
Excludes
- Contusion of toe (S90.1, S90.2)
Clinical Validation Requirements
- X-ray confirmation of fracture
Coding Notes
Document the type and location of the fracture.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified fall
W19.XXXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Toe Injury to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S90.1.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Thorough physical examination, Detailed documentation of nail condition
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for clinical analysis.
Mitigation Strategy
Always specify laterality when coding toe injuries.
Impact
Reimbursement: Incorrect coding can lead to claim rejections., Compliance: Violates ICD-10 coding rules., Data Quality: Affects longitudinal patient data tracking.
Mitigation Strategy
Ensure the correct 7th character is used for the encounter type.
Impact
High risk of audit for using unspecified codes.
Mitigation Strategy
Always specify laterality 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 Toe Injury, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Toe Injury
Use these documentation templates to ensure complete and accurate documentation for Toe Injury. These templates include all required elements for proper coding and billing.
Contusion with nail damage
Specialty: PodiatryRequired Elements
- Patient details
- Mechanism of injury
- Physical exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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