Coding fractures in ICD10: Difference between revisions
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**Others identify a group of related bones, e.g: '''[[Ankle or foot or toes, 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]]''' | **And some are for when you only know the general region, e.g: '''[[Upper limb (arm) bones, level not specified/NOS, fracture, injury/trauma]]''' | ||
{{ListICD10Category | categoryName = Fracture}} | |||
*'''''For all such fractures''''', you MUST also code the mechanism of traumatic injury. | *'''''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]]''' | **If the mechanism of trauma is unknown or not among those listed, use '''[[Mechanism of injury: other NOS]]''' | ||
{{ListICD10Category | categoryName = Mechanism}} | {{ListICD10Category | categoryName = Mechanism}} | ||
Revision as of 08:53, 17 November 2017
Coding instructions
Main Categories
There are two main categories of fractures:
- Due to trauma/injury -- by definition these have a so-called external cause or mechanism of injury". This means that the fracture was due to something enternal 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 categtory 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:
- 1) Pathologic fractures due to neoplastic disease -- here a neoplasm involving bone is the factor that weakened the bone.
- 2) Pathologic fractures due to osteoporosis -- here osteoporosis is the factor that weakened the bone.
- 3) 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.
- 4) 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
- Also sometimes relevant will be: Bone, disorder of bone continuity NOS