ICD-10 Coding for Calcaneus Fracture(S92.0, S92061A)
Complete ICD-10-CM coding and documentation guide for Calcaneus Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Calcaneus Fracture
S92.0Primary Range
Fracture of calcaneus
This range covers all types of calcaneus fractures, including those with specific details like laterality and encounter type.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S92.0 | Fracture of calcaneus | Use when a calcaneus fracture is confirmed but lacks specific details like laterality or encounter type. |
|
| S92061A | Displaced intraarticular fracture of right calcaneus, initial encounter (closed) | Use for initial encounter of displaced intraarticular fracture of the right calcaneus. |
|
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 calcaneus fracture
Essential facts and insights about Calcaneus Fracture
Primary ICD-10-CM Codes for calcaneus fracture
Decision Criteria
clinical Criteria
- Radiographic confirmation of fracture
documentation Criteria
- Specify laterality and encounter type
Applicable To
- Calcaneal fracture
Excludes
- Stress fracture of calcaneus (M84.37-)
Clinical Validation Requirements
- Radiographic evidence of fracture
- CT scan for Sanders classification
Code-Specific Risks
- Incorrect use without specifying laterality or encounter type
Coding Notes
- Ensure documentation specifies laterality and encounter type for accurate coding.
S92061A - Displaced intraarticular fracture of right calcaneus, initial encounter (closed)
Use for initial encounter of displaced intraarticular fracture of the right calcaneus.
Applicable To
- Displaced fracture of right calcaneus
Clinical Validation Requirements
- CT scan showing displaced intraarticular fracture
Coding Notes
Ensure documentation includes displacement and laterality.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Stress fracture of calcaneus
M84.37-Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Stress fracture of calcaneus
M84.37-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Calcaneus Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S92.0.
Impact
Clinical: Leads to vague clinical records, Regulatory: Non-compliance with coding standards, Financial: Potential for claim rejections
Mitigation Strategy
Always specify laterality and encounter type, Use detailed imaging reports
Impact
Reimbursement: Potential claim denial or reduced payment, Compliance: Non-compliance with ICD-10 coding guidelines, Data Quality: Inaccurate patient records
Mitigation Strategy
Always specify right or left calcaneus in the documentation.
Impact
Failure to document laterality and encounter type
Mitigation Strategy
Implement checklist for documentation completeness
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 Calcaneus Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Calcaneus Fracture
Use these documentation templates to ensure complete and accurate documentation for Calcaneus Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for displaced calcaneus fracture
Specialty: OrthopedicsRequired Elements
- Patient demographics
- Mechanism of injury
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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