ICD-10 Coding for Left 5th Metatarsal Fracture(S92.355A, S92.353A)
Complete ICD-10-CM coding and documentation guide for Left 5th Metatarsal Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left 5th Metatarsal Fracture
S92.35Primary Range
Fracture of fifth metatarsal bone
This range includes all fractures of the fifth metatarsal, specifying laterality and displacement.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S92.355A | Nondisplaced fracture of fifth metatarsal bone, left foot, initial encounter for closed fracture | Use for initial encounters with nondisplaced fractures of the left fifth metatarsal. |
|
| S92.353A | Displaced fracture of fifth metatarsal bone, left foot, initial encounter for closed fracture | Use for initial encounters with displaced fractures of the left fifth metatarsal. |
|
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 left 5th metatarsal fracture
Essential facts and insights about Left 5th Metatarsal Fracture
Primary ICD-10-CM Codes for left 5th metatarsal fracture
Decision Criteria
clinical Criteria
- Imaging shows no displacement
documentation Criteria
- Documented as initial encounter
Applicable To
- Nondisplaced fracture of the left fifth metatarsal
Excludes
- Stress fracture of the left fifth metatarsal
Clinical Validation Requirements
- X-ray confirmation of nondisplacement
- Clinical documentation of initial encounter
Code-Specific Risks
- Incorrectly coding as displaced when imaging shows nondisplacement
Coding Notes
- Ensure documentation specifies 'nondisplaced' and 'initial encounter'.
S92.353A - Displaced fracture of fifth metatarsal bone, left foot, initial encounter for closed fracture
Use for initial encounters with displaced fractures of the left fifth metatarsal.
Applicable To
- Displaced fracture of the left fifth metatarsal
Excludes
- Nondisplaced fracture of the left fifth metatarsal
Clinical Validation Requirements
- Imaging showing displacement
- Clinical documentation of initial encounter
Coding Notes
Ensure documentation specifies 'displaced' and 'initial encounter'.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Displaced fracture of fifth metatarsal bone, left foot, initial encounter for closed fracture
S92.353ANondisplaced fracture of fifth metatarsal bone, left foot, initial encounter for closed fracture
S92.355ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left 5th Metatarsal Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S92.355A.
Impact
Clinical: Ambiguity in treatment location, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always specify left or right in documentation, Use templates that prompt for laterality
Impact
Reimbursement: Claims may be denied if 'S' is used incorrectly., Compliance: Incorrect use can lead to compliance issues., Data Quality: Misuse affects data accuracy and patient records.
Mitigation Strategy
Ensure 'S' is only used when a sequela is present and documented.
Impact
Incorrect use of seventh characters can lead to audit flags.
Mitigation Strategy
Educate staff on proper seventh character usage based on encounter type.
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 Left 5th Metatarsal Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left 5th Metatarsal Fracture
Use these documentation templates to ensure complete and accurate documentation for Left 5th Metatarsal Fracture. These templates include all required elements for proper coding and billing.
Initial Encounter for Left 5th Metatarsal Fracture
Specialty: OrthopedicsRequired Elements
- Patient demographics
- Mechanism of injury
- 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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