ICD-10 Coding for Fracture of Foot(S92.011A, S92.012B)
Complete ICD-10-CM coding and documentation guide for Fracture of Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fracture of Foot
S92.0-S92.9Primary Range
Fractures of foot, except ankle
This range covers all types of fractures specific to the foot, excluding the ankle.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S92.011A | Displaced fracture of right calcaneus, initial encounter | Use when documenting a displaced fracture of the right calcaneus during the initial encounter. |
|
| S92.012B | Nondisplaced fracture of left calcaneus, initial encounter | Use when documenting a nondisplaced fracture of the left calcaneus during the initial encounter. |
|
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 displaced fracture of right calcaneus
Essential facts and insights about Fracture of Foot
Primary ICD-10-CM Codes for fracture of foot
Decision Criteria
clinical Criteria
- Presence of a displaced fracture confirmed by imaging
documentation Criteria
- Initial encounter with specified laterality and displacement
Applicable To
- Displaced fracture of right calcaneus
Clinical Validation Requirements
- X-ray or CT confirming displaced fracture
- Documentation of initial encounter
Code-Specific Risks
- Assuming laterality without documentation
- Incorrect episode of care
Coding Notes
- Ensure documentation specifies laterality and displacement status.
S92.012B - Nondisplaced fracture of left calcaneus, initial encounter
Use when documenting a nondisplaced fracture of the left calcaneus during the initial encounter.
Applicable To
- Nondisplaced fracture of left calcaneus
Excludes
- Ankle fractures (S82.5XX*)
- Traumatic amputation (S98)
Clinical Validation Requirements
- X-ray or CT confirming nondisplaced fracture
- Documentation of initial encounter
Coding Notes
Ensure documentation specifies laterality and displacement status.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fall from height, initial encounter
W19.XXXADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Ankle fractures
S82.5XX*Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fracture of Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S92.011A.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document displacement status in the medical record.
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Always verify and document the laterality of the fracture.
Impact
Reimbursement: Incorrect coding can lead to improper billing., Compliance: Violates coding standards., Data Quality: Affects continuity of care records.
Mitigation Strategy
Ensure the episode of care is clearly documented as initial, subsequent, or sequela.
Impact
Failure to document laterality can lead to audit issues.
Mitigation Strategy
Implement a checklist to ensure laterality is documented for all fractures.
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 Fracture of Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture of Foot
Use these documentation templates to ensure complete and accurate documentation for Fracture of Foot. These templates include all required elements for proper coding and billing.
Initial encounter for foot fracture
Specialty: OrthopedicsRequired Elements
- Patient history
- Mechanism of injury
- Imaging results
- Fracture details (type, displacement, laterality)
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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