ICD-10 Coding for Hip Fracture(S72.141A, M80.051D)
Complete ICD-10-CM coding and documentation guide for Hip Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hip Fracture
S72.0-S72.2Primary Range
Fracture of femur
This range includes all types of hip fractures, such as intracapsular, intertrochanteric, and subtrochanteric fractures.
Pathological fractures
This range covers fractures due to underlying conditions like osteoporosis or neoplastic 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 |
|---|---|---|---|
| S72.141A | Displaced intertrochanteric fracture of right femur, initial encounter for closed fracture | Use for initial encounter of a traumatic displaced intertrochanteric fracture of the right femur. |
|
| M80.051D | Age-related osteoporosis with pathological fracture, right hip, subsequent encounter with routine healing | Use for subsequent encounters of a pathological fracture 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 hip fracture
Essential facts and insights about Hip Fracture
Primary ICD-10-CM Codes for hip fracture
Decision Criteria
clinical Criteria
- Patient presents with trauma-induced hip fracture confirmed by imaging.
Applicable To
- Displaced intertrochanteric fracture
Excludes
- Pathological fracture
Clinical Validation Requirements
- X-ray confirmation of fracture
- Clinical documentation of trauma
Code-Specific Risks
- Incorrect laterality
- Unspecified fracture type
Coding Notes
- Ensure laterality and fracture type are specified.
M80.051D - Age-related osteoporosis with pathological fracture, right hip, subsequent encounter with routine healing
Use for subsequent encounters of a pathological fracture due to osteoporosis.
Applicable To
- Osteoporosis-related fracture
Excludes
- Traumatic fracture
Clinical Validation Requirements
- DEXA scan showing osteoporosis
- Clinical documentation of minor trauma or spontaneous fracture
Coding Notes
Ensure documentation supports osteoporosis as the cause.
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.
Age-related osteoporosis with pathological fracture, right hip, subsequent encounter with routine healing
M80.051DDisplaced intertrochanteric fracture of right femur, initial encounter for closed fracture
S72.141ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hip Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.141A.
Impact
Clinical: Leads to incorrect treatment planning., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Always document left or right in the medical record., Double-check imaging reports.
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Non-compliance with coding standards., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always specify laterality, fracture type, and encounter type.
Impact
High risk of audits due to frequent errors in fracture type and laterality.
Mitigation Strategy
Implement double-check systems for coding accuracy.
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 Hip Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hip Fracture
Use these documentation templates to ensure complete and accurate documentation for Hip Fracture. These templates include all required elements for proper coding and billing.
Initial encounter for traumatic hip fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging results
- Fracture type and laterality
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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