ICD-10 Coding for Left Elbow Fracture(S42.402A, S52.022A, S52.112A)
Complete ICD-10-CM coding and documentation guide for Left Elbow Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Elbow Fracture
S42.4-S42.49Primary Range
Fracture of lower end of humerus
Covers fractures of the lower end of the humerus, including the elbow.
Fracture of forearm
Includes fractures of the olecranon and radial head, which are part of the elbow joint.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S42.402A | Unspecified fracture of lower end of left humerus, initial encounter for closed fracture | Use when the fracture is unspecified but confirmed to be at the lower end of the left humerus. |
|
| S52.022A | Displaced fracture of olecranon process of left ulna, initial encounter for closed fracture | Use for displaced fractures of the olecranon process of the left ulna. |
|
| S52.112A | Displaced fracture of left radial head, initial encounter for closed fracture | Use for displaced fractures of the left radial head. |
|
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 elbow fracture
Essential facts and insights about Left Elbow Fracture
Primary ICD-10-CM Codes for left elbow fracture
Decision Criteria
documentation Criteria
- Document the fracture as being at the lower end of the left humerus.
Applicable To
- Fracture of left elbow
Excludes
- Fracture of right elbow
Clinical Validation Requirements
- X-ray confirming fracture without displacement or open wound
Code-Specific Risks
- Risk of using this code without specifying the fracture type or displacement.
Coding Notes
- Ensure laterality and encounter type are clearly documented.
S52.022A - Displaced fracture of olecranon process of left ulna, initial encounter for closed fracture
Use for displaced fractures of the olecranon process of the left ulna.
Applicable To
- Displaced fracture of left olecranon
Excludes
- Non-displaced fracture of olecranon
Clinical Validation Requirements
- CT scan showing >3mm displacement
Coding Notes
Document the degree of displacement and confirm with imaging.
S52.112A - Displaced fracture of left radial head, initial encounter for closed fracture
Use for displaced fractures of the left radial head.
Applicable To
- Displaced fracture of left radial head
Excludes
- Non-displaced fracture of radial head
Clinical Validation Requirements
- X-ray showing fragmentation
Coding Notes
Document the presence of fragmentation and confirm with imaging.
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.
Unspecified fracture of lower end of right humerus, initial encounter for closed fracture
S42.401ADisplaced fracture of coronoid process of left ulna, initial encounter for closed fracture
S52.032ANon-displaced fracture of left radial head, initial encounter for closed fracture
S52.111ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Elbow Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.402A.
Impact
Clinical: Leads to inaccurate clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Review documentation for laterality before coding.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 requirements., Data Quality: Poor data quality and inaccurate patient records.
Mitigation Strategy
Always specify left or right in the documentation.
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Implement mandatory fields for laterality in EHR systems.
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 Elbow Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Elbow Fracture
Use these documentation templates to ensure complete and accurate documentation for Left Elbow Fracture. These templates include all required elements for proper coding and billing.
Initial Encounter for Left Elbow Fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Clinical findings
- Imaging results
- Fracture specifics
- Treatment plan
- Encounter type
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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