Coding fractures in ICD10: Difference between revisions
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There are two main categories of fractures: | There are two main categories of fractures: | ||
*[[ | *[[Fractures due to trauma or injury]] -- by definition these have a so-called '''external''' cause or mechanism of injury". This means that the fracture was due to something external to the patient, such as getting hit by a baseball bat, or hitting their head on the pavement after falling off a ladder. | ||
*[[#Nontraumatic fractures]] -- for these the main cause is something ''internal'' to the patient, such as a metastatic tumor to bone that weakens it. | *[[#Nontraumatic fractures]] -- for these the main cause is something ''internal'' to the patient, such as a metastatic tumor to bone that weakens it. | ||
**While in these cases the fracture might well happen after some relatively minor stress to that bone (e.g. trying to open a jar of pickles, or lifting a heavy book), these should be included in the nontraumatic fracture category unless that stress would have led to a fracture in the absence of whatever weakened the bone. | **While in these cases the fracture might well happen after some relatively minor stress to that bone (e.g. trying to open a jar of pickles, or lifting a heavy book), these should be included in the nontraumatic fracture category unless that stress would have led to a fracture in the absence of whatever weakened the bone. | ||
Revision as of 14:28, 6 December 2017
There are two main categories of fractures:
- Fractures due to trauma or injury -- by definition these have a so-called external cause or mechanism of injury". This means that the fracture was due to something external to the patient, such as getting hit by a baseball bat, or hitting their head on the pavement after falling off a ladder.
- #Nontraumatic fractures -- for these the main cause is something internal to the patient, such as a metastatic tumor to bone that weakens it.
- While in these cases the fracture might well happen after some relatively minor stress to that bone (e.g. trying to open a jar of pickles, or lifting a heavy book), these should be included in the nontraumatic fracture category unless that stress would have led to a fracture in the absence of whatever weakened the bone.
Fractures due to trauma or injury
- For fractures due to external causes i.e. trauma or injury, there are specific codes identifying the bone in question.
- Some of these are specific for a single bone, e.g: Femur, fracture, injury/trauma
- Others identify a group of related bones, e.g: Ankle or foot or toes, fracture, injury/trauma
- And some are for when you only know the general region, e.g: Upper limb (arm) bones, level not specified/NOS, fracture, injury/trauma
- For all such fractures, you MUST also code the mechanism of traumatic injury.
- If the mechanism of trauma is unknown or not among those listed, use Mechanism of injury: other NOS
Nontraumatic fractures
Here there are fewer codes, and the only bones for which we have specific codes are femur/pelvis and vertebrae. Nontraumatic fractures fall into 4 main subcategories:
- Pathologic fractures due to neoplastic disease -- here a neoplasm involving bone is the factor that weakened the bone.
- Pathologic fractures due to osteoporosis -- here osteoporosis is the factor that weakened the bone.
- Stress fractures -- note here we have just one code, no codes for specific bones (i.e. it's one-size-fits-all for this type of fracture). These are due to repetitive stress rather than a single big event.
- Nontraumatic fractures NOS -- these are for nontraumatic fractures that don't fit into the other categories listed immediately above.
- Femur or pelvis, nontraumatic fracture NOS
- Vertebra, nontraumatic fracture NOS -- this includes vertebral compression/wedge fractures not due to neoplasm or osteoporosis.
- Bone NOS, nontraumatic fracture NOS