Stress fracture, hip, unspecified, sequela
Signs and symptoms of a hip fracture include:
Unspecified fracture of left femur, initial encounter for closed fracture
Fracture during Total Hip Replacement
Code Z47. 1 (aftercare following joint replacement surgery) is used during the follow-up phase of any joint replacement surgery, even if the replacement was for treatment of a fracture. It must be accompanied by a code from subcategory Z96. 6, which identifies the specific joint location and laterality (Table 1).
Aftercare following explantation of hip joint prosthesis The 2022 edition of ICD-10-CM Z47. 32 became effective on October 1, 2021.
Presence of other orthopedic joint implants Z96. 698 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z96. 698 became effective on October 1, 2021.
ICD-10-CM S72. 002A is grouped within Diagnostic Related Group(s) (MS-DRG v39.0): 521 Hip replacement with principal diagnosis of hip fracture with mcc. 522 Hip replacement with principal diagnosis of hip fracture without mcc.
ICD-10-CM S72. 001A is grouped within Diagnostic Related Group(s) (MS-DRG v39.0): 521 Hip replacement with principal diagnosis of hip fracture with mcc. 522 Hip replacement with principal diagnosis of hip fracture without mcc.
Pathological fracture, hip, unspecified, initial encounter for fracture. M84. 459A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M84.
ICD-10-CM Code for Encounter for other orthopedic aftercare Z47. 89.
The 2022 edition of ICD-10-CM S72. 142A became effective on October 1, 2021. This is the American ICD-10-CM version of S72. 142A - other international versions of ICD-10 S72.
ICD-10-CM Code for Encounter for surgical aftercare following surgery on specified body systems Z48. 81.
Fracture of femur ICD-10-CM S72. 309A is grouped within Diagnostic Related Group(s) (MS-DRG v39.0):
ICD-9-CM and ICD-10-CM CodesOsteoporosis ICD-9-CM & ICD-10-CM CodesDisuse osteoporosis: 733.03M81.8Other osteoporosis: 733.09M81.8FRAGILITY FRACTURESHip fracture: 820.0, 820.2, 733.14S72.019A, S72.023A, S72.033A, S72.043A, S72.099A, S72.109A, S72.143A, S72.23XA, M84.459A12 more rows
A femur fracture is a break, crack, or crush injury of the thigh bone. It is sometimes referred to as a hip fracture or broken hip when the break is in the upper part of the bone near the hip joint area. Femur fractures that are simple, short cracks in the bone usually do not require surgery.
When the reason for an encounter is aftercare following a procedure or injury, the 2012 ICD-10-CM Official Guidelines and Reporting should be consulted to ensure that the correct code is assigned. Codes for reporting most types of aftercare are found in Chapter 21. However, aftercare related to injuries is reported with codes from Chapter 19, using seventh-character extensions to identify the service as aftercare.
Aftercare visit codes cover situations occurring when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or care for the long-term consequences of the disease.
The codes for factors influencing health and contact with health services represent reasons for encounters. In ICD-10-CM, these codes are located in Chapter 21 and have the initial alpha character of “Z,” so codes in this chapter eventually may be referred to as “Z-codes” (just as the same supplementary codes in ICD-9-CM were referred to as “V-codes”). While code descriptions in Chapter 21, such as aftercare, may appear to denote descriptions of services or procedures, they are not procedure codes. These codes represent the reason for the encounter, service or visit, and the procedure must be reported with the appropriate procedure code.
Codes for encounters for antineoplastic radiation, chemotherapy and immunotherapy (Z51.0, Z51.1-) are assigned if the sole reason for the encounter is antineoplastic therapy – even if the patient still has the neoplastic disease.
If the line between acceptable and unacceptable uses of aftercare codes still seems a bit fuzzy, just remember that in most cases, you should only use aftercare codes if there’s no other way for you to express that a patient is on the “after” side of an aforementioned “before-and-after” event.
ICD-10 introduced the seventh character to streamline the way providers denote different encounter types—namely, those in volving active treatment versus those involving subsequent care. However, not all ICD-10 diagnosis codes include the option to add a seventh character. For example, most of the codes contained in chapter 13 of the tabular list (a.k.a. the musculoskeletal chapter) do not allow for seventh characters. And that makes sense considering that most of those codes represent conditions—including bone, joint, or muscle conditions that are recurrent or resulting from a healed injury—for which therapy treatment does progress in the same way it does for acute injuries.
Essentially, you are indicating that the patient is receiving aftercare for the injury. Thus, you should not use aftercare codes in conjunction with injury codes, because doing so would be redundant. 3. You can use Z codes to code for surgical aftercare.
In situations where it’s appropriate to use Z codes, “aftercare codes are generally the first listed diagnosis,” Gray writes. However, that doesn’t mean the Z code should be the only diagnosis code listed for that patient.
Even so, therapists should only use ICD-10 aftercare codes to express patient diagnoses in a very select set of circumstances.