ICD-10 Coding for Left Hip Hemiarthroplasty(S72.002A, M16.12)
Complete ICD-10-CM coding and documentation guide for Left Hip Hemiarthroplasty. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Hip Hemiarthroplasty
S72.0-S72.9Primary Range
Fracture of femur
This range includes codes for fractures of the femur, which are relevant for coding hemiarthroplasty procedures performed due to fractures.
Osteoarthritis of hip
This range includes codes for osteoarthritis of the hip, relevant for coding hemiarthroplasty procedures performed due to degenerative conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.002A | Fracture of unspecified part of neck of left femur, initial encounter | Use for acute femoral neck fractures treated with hemiarthroplasty. |
|
| M16.12 | Primary osteoarthritis, left hip | Use for degenerative conditions leading to hemiarthroplasty. |
|
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 hip hemiarthroplasty fracture
Essential facts and insights about Left Hip Hemiarthroplasty
Primary ICD-10-CM Codes for left hip hemiarthroplasty
Decision Criteria
clinical Criteria
- Presence of acute fracture confirmed by imaging
documentation Criteria
- Operative note must specify components implanted
Applicable To
- Displaced femoral neck fracture
Excludes
- Pathological fracture
Clinical Validation Requirements
- Pre-op imaging confirming fracture
- Operative note specifying femoral stem and bipolar head implanted
Code-Specific Risks
- Incorrectly coding as degenerative condition
Coding Notes
- Ensure documentation specifies fracture and laterality.
M16.12 - Primary osteoarthritis, left hip
Use for degenerative conditions leading to hemiarthroplasty.
Applicable To
- Degenerative joint disease
Excludes
- Traumatic arthritis
Clinical Validation Requirements
- History of osteoarthritis
- Imaging showing degenerative changes
Coding Notes
Ensure documentation supports degenerative etiology.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Hip Hemiarthroplasty to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.002A.
Impact
Clinical: Leads to ambiguity in treatment records., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use templates with mandatory fields, Cross-check documentation
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May trigger audits for incorrect coding., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Use 27236 for fractures with S72.002A.
Impact
Using codes for degenerative conditions in fracture cases.
Mitigation Strategy
Regular training on code differentiation.
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 Hip Hemiarthroplasty, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Hip Hemiarthroplasty
Use these documentation templates to ensure complete and accurate documentation for Left Hip Hemiarthroplasty. These templates include all required elements for proper coding and billing.
Hemiarthroplasty for femoral neck fracture
Specialty: Orthopedic SurgeryRequired Elements
- Pre-op diagnosis
- Procedure details
- Implants used
- Post-op plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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