subsequent encounter for fracture of the left clavicle, with delayed healing. icd-10-cm code(s)

by Chet Kuhlman 9 min read

Displaced fracture of shaft of left clavicle, subsequent encounter for fracture with delayed healing. S42. 022G 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 S42.

What is the ICD 10 code for fracture of the left clavicle?

2018/2019 ICD-10-CM Diagnosis Code S42.002D. Fracture of unspecified part of left clavicle, subsequent encounter for fracture with routine healing. 2016 2017 2018 2019 Billable/Specific Code POA Exempt. S42.002D is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is the new ICD 10 for clavicle pain?

Short description: Fx unsp part of l clavicle, subs for fx w routn heal The 2021 edition of ICD-10-CM S42.002D became effective on October 1, 2020.

What does subsequent mean in ICD 10?

Subsequent Indicates Recovery. ICD-10-CM defines subsequent encounters as “encounters after the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase. Examples of subsequent care are: cast change or removal, removal of external or internal fixation device,...

What is a sequela in ICD 10?

Defining Sequela ICD-10-CM says the seventh character S is “for use for complications or conditions that arise as a direct result of an injury, such as scar formation after a burn. The scars are sequelae of the burn.” In other words, sequela are the late effects of an injury.

What is the ICD-10 code for injury of left clavicle?

S42.002A2022 ICD-10-CM Diagnosis Code S42. 002A: Fracture of unspecified part of left clavicle, initial encounter for closed fracture.

What is the ICD-10 code for midshaft clavicle fracture?

ICD-10-CM Code for Fracture of clavicle S42. 0.

What is the ICD 9 code for fracture of clavicle?

810.02 Closed fracture of shaft of clavicle.

What type of fracture is a clavicle fracture?

Clavicle fractures are classified into three types based on the location of the fracture: 1) near the sternum (least common), 2) near the AC joint (second most common), or 3) in the middle of the bone between the sternum and AC joint (most common).

What is the ICD 10 code for distal clavicle fracture?

Displaced fracture of lateral end of right clavicle, initial encounter for closed fracture. S42. 031A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is the distal clavicle?

Distal clavicle excision is a procedure which involves removal of the outer end of the clavicle (collarbone) to treat shoulder pain and disability due to arthritis or impingement.

What is an ICD 10 diagnosis code?

Used for medical claim reporting in all healthcare settings, ICD-10-CM is a standardized classification system of diagnosis codes that represent conditions and diseases, related health problems, abnormal findings, signs and symptoms, injuries, external causes of injuries and diseases, and social circumstances.

When do you use external cause codes?

The external cause-of-injury codes are the ICD codes used to classify injury events by mechanism and intent of injury. Intent of injury categories include unintentional, homicide/assault, suicide/intentional self-harm, legal intervention or war operations, and undetermined intent.

What Are diagnosis codes used for?

Diagnosis codes describe an individual's medical condition and are required on claims submitted by health care professionals to third party payers.

What is a medial clavicle fracture?

Medial clavicle fractures most commonly occur in middle-aged men. They most commonly are extra-articular fractures with minimal or no displacement. The current literature shows that nonoperative treatment of these fractures results in high union rate and overall “good” functional outcome (low quality of evidence).

Is clavicle the same as collarbone?

Your clavicle (collarbone) is a long, thin, slightly curved bone that connects your arm to your body. It sits below your neck and is part of the front of your shoulder. It runs horizontally (from side to side). This bone connects your sternum in the middle of your ribcage to your shoulder blade (scapula).

What is a closed fracture of the clavicle?

A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. This type of fracture is fairly common, accounting for about 5% of all adult fractures. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks.

What is the ICd 10 code for a fractured clavicle?

Displaced fracture of shaft of left clavicle, subsequent encounter for fracture with nonunion 1 S42.022K is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 Short description: Disp fx of shaft of left clavicle, subs for fx w nonunion 3 The 2021 edition of ICD-10-CM S42.022K became effective on October 1, 2020. 4 This is the American ICD-10-CM version of S42.022K - other international versions of ICD-10 S42.022K may differ.

What is the secondary code for Chapter 20?

Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.

What is the 7th character in ICd 10?

ICD-10-CM says the seventh character S is “for use for complications or conditions that arise as a direct result of an injury, such as scar formation after a burn. The scars are sequelae of the burn.” In other words, sequela are the late effects of an injury.#N#Perhaps the most common sequela is pain. Many patients receive treatment long after an injury has healed as a result of pain. Some patients might never have been treated for the injury at all. As time passes, the pain becomes intolerable and the patient seeks a pain remedy.#N#A late effect can occur only after the acute phase of the injury or illness has passed; therefore, you cannot report a code for the acute illness and a code for the late effect at the same encounter, for the same patient. The only exception occurs if both conditions exist (for example, the patient has a current cerebrovascular condition and deficits from an old cerebrovascular condition).#N#When reporting sequela (e), you usually will need to report two codes. The first describes the condition or nature of the sequela (e) and second the second describes the sequela (e) or “late effect.” For example, you may report M81.8 Other osteoporosis without current pathological fracture with E64.8 Sequelae of other nutritional deficiencies (calcium deficiency).#N#If a late effect code describes all of the relevant details, you should report that one code, only (e.g., I69.191 Dysphagia following nontraumatic intracerebral hemorrhage ).#N#For example: A patient suffers a low back injury that heals on its own. The patient isn’t seeking intervention for the initial injury, but for the pain that persists long after. The chronic pain is sequela of the injury. Such a visit may be reported as G89.21 Chronic pain due to trauma and S39.002S Unspecified injury of muscle, fascia and tendon of lower back, sequela.

What is a subsequent encounter?

ICD-10-CM defines subsequent encounters as “encounters after the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase. Examples of subsequent care are: cast change or removal, removal of external or internal fixation device, medication adjustment, other aftercare and follow up visits following injury treatment.”#N#A seventh character “D” is appropriate during the recovery phase, no matter how many times he has seen the provider for this problem, previously.#N#Note that ICD-10-CM guidelines do not definitively establish when “active treatment” becomes “routine care.” Active treatment occurs when the provider sees the patient and develops a plan of care. When the patient is following the plan, that is subsequent. If the provider needs to adjust the plan of care—for example, if the patient has a setback or must returns to the OR—the care becomes active, again.

What is sequela in medical terms?

In other words, sequela are the late effects of an injury. Perhaps the most common sequela is pain. Many patients receive treatment long after an injury has healed as a result of pain. Some patients might never have been treated for the injury at all.

Can you report a late effect on a patient?

A late effect can occur only after the acute phase of the injury or illness has passed; therefore, you cannot report a code for the acute illness and a code for the late effect at the same encounter, for the same patient.

Is chronic pain a sequela of an injury?

The patient isn’t seeking intervention for the initial injury, but for the pain that persists long after. The chronic pain is sequela of the injury.

The ICD code S420 is used to code Clavicle fracture

A clavicle fracture is a bone fracture in the clavicle, or collarbone. It is often caused by a fall onto an outstretched upper extremity, a fall onto a shoulder, or a direct blow to the clavicle. Many research projects are underway regarding the medical healing process of clavicle fractures.

MS-DRG Mapping

DRG Group #559-561 - Aftercare, musculoskeletal system and connective tissue with MCC.

Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)

This is the official approximate match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that while there is no exact mapping between this ICD10 code S42.025D and a single ICD9 code, V54.19 is an approximate match for comparison and conversion purposes.