Forum - Questions & Answers
Fracture code
I need help in determining why the following code is incorrect:
Child has a displaced comminuted fracture of shaft of radius right arm, initial encounter in Emergency Room
Code - S52.351A
What makes this code incorrect? I'm just not seeing it!
re: Fracture code
Maybe they are looking for more information. I was told on injury claims we need at least 4 codes. I could be wrong.
ICD-10 Code Examples
Example 1: A left knee strain injury that occurred on a private recreational playground when a child landed incorrectly from a trampoline:
Injury: S86.812A, Strain of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
External cause: W09.8xxA, Fall on or from other playground equipment, initial encounter
Place of occurrence: Y92.838, Other recreation area as the place of occurrence of the external cause
Activity: Y93.44, Activities involving rhythmic movement, trampoline jumping
re: Fracture code
What makes you think it is incorrect? it is a valid code. Does it describe the patient's injury?
Did you get a denial?
The external cause codes are "optional" per ICD-10 general guidelines, but your payer may require them.
There are three additional occurrence codes. I don't recommend using them, again, unless your payer requires them. I have heard that payers are requiring an external cause code, but have not heard of anyone requiring occurrence codes.
Good luck
Betsy