ICD-10 Coding for Fractured Femur(S72.001A, M80.051D)
Complete ICD-10-CM coding and documentation guide for Fractured Femur. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fractured Femur
S72.0-S72.9Primary Range
Fracture of femur
This range covers all types of femoral fractures, including neck, shaft, and distal end fractures.
Osteoporosis with current pathological fracture
Relevant for fractures due to osteoporosis, indicating a pathological cause.
Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate
Used for periprosthetic fractures occurring around orthopedic implants.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.001A | Fracture of unspecified part of neck of femur, initial encounter for closed fracture | Use for initial encounter of a closed femoral neck fracture when specific location is not documented. |
|
| M80.051D | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter | Use for subsequent encounters of pathological fractures due to osteoporosis. |
|
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 fractured femur
Essential facts and insights about Fractured Femur
Primary ICD-10-CM Codes for fractured femur
Decision Criteria
clinical Criteria
- Confirmed fracture via imaging
documentation Criteria
- Detailed description of fracture type and location
Applicable To
- Closed fracture of femoral neck
Excludes
- Pathological fracture (M84.4-)
Clinical Validation Requirements
- X-ray or CT scan confirming fracture
- Clinical examination indicating fracture
Code-Specific Risks
- Ensure laterality is documented to avoid unspecified coding.
Coding Notes
- Ensure to document the type of fracture and any associated conditions.
M80.051D - Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter
Use for subsequent encounters of pathological fractures due to osteoporosis.
Applicable To
- Pathological fracture due to osteoporosis
Excludes
- Traumatic fracture (S72.-)
Clinical Validation Requirements
- Bone density scan showing osteoporosis
- Clinical history of osteoporosis
Coding Notes
Document the underlying osteoporosis and fracture details.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified fall, initial encounter
W19.xxxADifferential 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 Fractured Femur to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.001A.
Impact
Clinical: Incomplete patient history., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Always document how the injury occurred., Use appropriate external cause codes.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Always document and code the laterality of the fracture.
Impact
Risk of audits due to incorrect coding of fracture type or laterality.
Mitigation Strategy
Implement regular training for coding staff on fracture coding guidelines.
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 Fractured Femur, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fractured Femur
Use these documentation templates to ensure complete and accurate documentation for Fractured Femur. These templates include all required elements for proper coding and billing.
Initial encounter for closed femoral neck fracture
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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