Coding fractures in ICD10

Coding instructions

• There are two main categories of fractures: (a) due to trauma/injury, and (b) nontraumatic fractures
• For fractures due to external causes i.e. trauma or injury, there are a number of specific codes identifying the bone in question.
  • Some of these are quite specific for the bone, e.g: Femur, fracture, injury/trauma
  • Others identify a group of bones, e.g: Ankle or foot or toes, fracture, injury/trauma
  • And some 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

• For nontraumatic fracture, there are fewer codes, and the only bones that have specific codes are femur/pelvis and vertebrae. Nontraumatic fractures fall into 4 main subcategories:

• Pathologic fractures due to neoplastic disease
  • Femur or pelvis, pathologic fracture due to neoplastic disease
  • Spine, pathologic fracture due to neoplastic disease
  • Bone NOS, pathologic fracture due to neoplastic disease

• Pathologic fractures due to osteopororis
  • Femur or pelvis, osteoporosis with new pathologic fracture
  • Vertebrae, osteoporosis with new pathologic fracture
  • Bone NOS, osteoporosis with new pathologic fracture

• Stress fractures -- note here we have just one code, not special codes for specific bones
  • Bone, stress fracture

• Nontraumatic fractures NOS
  • Femur or pelvis, nontraumatic fracture NOS
  • Vertebrae, nontraumatic fracture NOS
  • Bone NOS, nontraumatic fracture NOS

• Also sometimes relevant will be:
  • Bone, disorder of bone continuity NOS

you should also code the cause, e.g:

• • Bone, pathologic fracture due to neoplastic disease
  • Osteoporosis with new pathologic fracture
  • Bone, stress fracture
  • Bone, pathologic fracture NOS
  • Bone, disorder of bone continuity