ICD-10 Coding for Right Calcaneus Fracture(S92.011A, S92.001A)
Complete ICD-10-CM coding and documentation guide for Right Calcaneus Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Calcaneus Fracture
S92.0-S92.9Primary Range
Fractures of foot and toe, except ankle
This range includes all fractures related to the foot and toes, specifically addressing calcaneus fractures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S92.011A | Displaced fracture of body of right calcaneus, initial encounter for closed fracture | Use when the fracture is displaced and closed, during the initial encounter. |
|
| S92.001A | Unspecified fracture of right calcaneus, initial encounter for closed fracture | Use when specific details about the fracture are not available. |
|
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 right calcaneus fracture
Essential facts and insights about Right Calcaneus Fracture
Primary ICD-10-CM Codes for right calcaneus fracture
Decision Criteria
clinical Criteria
- Displaced fracture confirmed by imaging
documentation Criteria
- Closed fracture with initial encounter
Applicable To
- Displaced fracture of right calcaneus body
Excludes
- Open fracture of right calcaneus
Clinical Validation Requirements
- X-ray showing displaced fracture
- Böhler’s angle < 15°
Code-Specific Risks
- Incorrect laterality documentation
- Omitting displacement status
Coding Notes
- Ensure laterality and displacement are documented.
S92.001A - Unspecified fracture of right calcaneus, initial encounter for closed fracture
Use when specific details about the fracture are not available.
Applicable To
- Fracture of right calcaneus, unspecified
Excludes
- Displaced fracture of right calcaneus
Clinical Validation Requirements
- Lack of specific imaging details
Coding Notes
Avoid using unless absolutely necessary due to lack of detail.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pathological fracture of right calcaneus
M84.57XADifferential 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 Right Calcaneus Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S92.011A.
Impact
Clinical: Leads to incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always document laterality in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit issues., Data Quality: Reduces the accuracy of clinical data.
Mitigation Strategy
Ensure all available clinical details are documented and used for coding.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure all clinical details are documented and used for coding.
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 Right Calcaneus Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Calcaneus Fracture
Use these documentation templates to ensure complete and accurate documentation for Right Calcaneus Fracture. These templates include all required elements for proper coding and billing.
Initial Encounter for Right Calcaneus Fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging results
- Fracture type and displacement
- Neurovascular status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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