ICD-10 Coding for Femur Fracture(S72.21XA, M84.552A)
Complete ICD-10-CM coding and documentation guide for Femur Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Femur Fracture
S72.0-S72.9Primary Range
Fracture of femur
This range includes all types of femur fractures, including subtrochanteric, intertrochanteric, and shaft fractures.
Pathological fracture
Used for fractures due to underlying conditions like osteoporosis or metastatic disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.21XA | Displaced subtrochanteric fracture of right femur, initial encounter | Use when a displaced subtrochanteric fracture is confirmed by imaging. |
|
| M84.552A | Pathological fracture in neoplastic disease, left femur, initial encounter | Use when a fracture is due to neoplastic disease, confirmed by imaging. |
|
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 femur fracture
Essential facts and insights about Femur Fracture
Primary ICD-10-CM Codes for femur fracture
Decision Criteria
clinical Criteria
- Presence of fracture line in subtrochanteric region
documentation Criteria
- Documentation of displacement and laterality
Applicable To
- Subtrochanteric fracture
Excludes
- Pathological fracture (M84.4-)
Clinical Validation Requirements
- Imaging confirming fracture location
- Clinical notes specifying displacement
Code-Specific Risks
- Incorrect laterality
- Missing displacement status
Coding Notes
- Ensure documentation specifies laterality and displacement.
M84.552A - Pathological fracture in neoplastic disease, left femur, initial encounter
Use when a fracture is due to neoplastic disease, confirmed by imaging.
Applicable To
- Pathological fracture due to cancer
Excludes
- Traumatic fracture (S72.0-S72.9)
Clinical Validation Requirements
- Imaging showing lytic lesions
- History of neoplastic disease
Coding Notes
Ensure underlying condition is coded first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Periprosthetic fracture around hip joint
M97.01XADifferential 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 Femur Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.21XA.
Impact
Clinical: May lead to incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of health data.
Mitigation Strategy
Always use the most specific code available based on documentation.
Impact
High risk of audits when unspecified codes are used despite available documentation.
Mitigation Strategy
Implement regular training on documentation specificity.
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 Femur Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Femur Fracture
Use these documentation templates to ensure complete and accurate documentation for Femur Fracture. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of femur fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging results
- Fracture specifics
- Comorbidities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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