ICD-10 Coding for Wrist Fracture(S62.501A, S52.575E)
Complete ICD-10-CM coding and documentation guide for Wrist Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Wrist Fracture
S62.0-S62.9Primary Range
Fractures of the wrist and hand
This range covers all fractures related to the wrist, including specific bones like the scaphoid and distal radius.
Fractures of the forearm
Includes fractures that extend from the wrist into the forearm, such as distal radius and ulna fractures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S62.501A | Fracture of unspecified carpal bone, right wrist, initial encounter for closed fracture | Use when the specific carpal bone is not identified but a fracture is confirmed. |
|
| S52.575E | Other intra-articular fracture of lower end of radius, right arm, subsequent encounter for open fracture type I or II with routine healing | Use for confirmed intra-articular fractures with open fracture classification. |
|
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 wrist fracture
Essential facts and insights about Wrist Fracture
Primary ICD-10-CM Codes for wrist fracture
Decision Criteria
clinical Criteria
- Presence of fracture confirmed by imaging
documentation Criteria
- Specific carpal bone not identified
Applicable To
- Carpal bone fracture
Excludes
- Fracture of radius and ulna (S52.-)
Clinical Validation Requirements
- X-ray confirmation of fracture
- Clinical examination indicating pain and swelling
Code-Specific Risks
- Risk of under-coding if specific bone is identified later
Coding Notes
- Ensure laterality and encounter type are documented.
S52.575E - Other intra-articular fracture of lower end of radius, right arm, subsequent encounter for open fracture type I or II with routine healing
Use for confirmed intra-articular fractures with open fracture classification.
Applicable To
- Intra-articular distal radius fracture
Excludes
- Fracture of carpal bones (S62.-)
Clinical Validation Requirements
- CT scan showing intra-articular extension
- Gustilo classification for open fracture
Coding Notes
Ensure Gustilo classification is documented for open fractures.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Wrist Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S62.501A.
Impact
Clinical: May affect continuity of care., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always include encounter type (initial, subsequent, sequela) in documentation.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Leads to poor data quality and inaccurate health records.
Mitigation Strategy
Ensure all available clinical details are documented and used for coding.
Impact
High risk of audit if unspecified codes are used when specific details are available.
Mitigation Strategy
Ensure all clinical details are documented and used for 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 Wrist Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Wrist Fracture
Use these documentation templates to ensure complete and accurate documentation for Wrist Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for wrist fracture
Specialty: OrthopedicsRequired Elements
- Fracture location and type
- Laterality
- Encounter type
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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