Unspecified sprain of left wrist, initial encounter
Types of complete fracture include:
You may have difficulty using your hands or wrist along with numbness and tingling in the fingers. There may be pain as you try to move your fingers, especially when trying to grip an object. Bruising is also a very common symptom associated with wrist fractures. What are the Symptoms of a hairline fracture of the wrist?
Unspecified fracture of the lower end of right radius, initial encounter for closed fracture. S52. 501A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Unspecified fracture of unspecified wrist and hand, initial encounter for closed fracture. S62. 90XA 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 S62.
A, Initial encounter for closed fracture. B, Initial encounter for open fracture. D, Subsequent encounter for fracture with routine healing. G, Subsequent encounter for fracture with delayed healing.
ICD-10 Code for Unspecified injury of right wrist, hand and finger(s), initial encounter- S69. 91XA- Codify by AAPC.
Example 1: An initial encounter (character “A”) describes an episode of care during which the patient is receiving active treatment for the condition. Examples of active treatment are: surgical treatment, emergency department encounter, and evaluation and continuing treatment by the same or a different physician.
Per ICD-10 guidelines, you would again report S52. 222A for an initial encounter.
The first is the alphabetic abbreviations “NEC” and “NOS.” NEC means “Not Elsewhere Classified” while NOS means “Not Otherwise Specified.” Simply put, NEC means the provider gave you a very detailed diagnosis, but the codes do not get that specific.
Closed fracture (also called simple fracture). The bone is broken, but the skin is intact.
Use 7th character A, initial encounter, “for each encounter where the patient is receiving active treatment for the condition.” The takeaway there is that “initial” does not always mean “first” for ICD-10-CM 7th characters.
Unspecified superficial injury of right hand, initial encounter. S60. 921A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
S69.91XAS69. 91XA - Unspecified injury of right wrist, hand and finger(s) [initial encounter]. ICD-10-CM.
M25. 532 Pain in left wrist - ICD-10-CM Diagnosis Codes.
The orthopedic specialist places a splint and wants to see the patient in two weeks. After one week, the patient is complaining of severe pain.
Both the treating physician and the consulting physician have provided active care, and both visits are initial encounters. Neither prescribing medicine, nor referral to a physical therapist, is considered active care for fracture coding.
Fracture coding can be a challenge for both physicians and coders, but its effect on hierarchical condition code (HCC) funding in Medicare Advantage, as well as health plan Star ratings, leaves little room for speculation. Knowing how ICD-10 delineates initial and subsequent visits is key.