ICD-10 code S82. 002A for Unspecified fracture of left patella, initial encounter for closed fracture is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
Stable patella fracture: In a stable fracture, also called a “nondisplaced” fracture, the broken pieces of your bone remain essentially in the right place. They may still be connected to each other, or they may be separated by a millimeter or two. This type of fracture usually heals well without surgery.
Fractures of the patella may result from either direct or indirect mechanisms. The classic indirect mechanism is a fall on the feet in which the quadriceps eccentrically fire to decelerate the body. When the force of the fall overwhelms the resistance to knee flexion, the extensor mechanism fails.
Nonsurgical Treatment If the pieces of bone are not out of place (displaced), you may not need surgery. Your doctor may apply a cast or splint to keep your knee straight and help prevent motion in your leg. This will keep the broken ends of bone in proper position while they heal.
Closed Fracture Most types of patella fractures are closed fractures, in which the patella does not break through the skin. Some types of closed fractures may be treated without surgery.
The most common fracture pattern is a simple 2-part diversion caused by a direct blow (i.e. dashboard injury). As a result of the bony lesion the extensor mechanism of the knee joint can become insufficient.
A patellar fracture is a break in the patella, or kneecap, the small bone that sits at the front of your knee. Because the patella acts as a shield for your knee joint, it is more likely to break if you fall directly onto your knee or hit it against the dashboard in a car accident.
Fractures of the inferior pole of the patella are a unique type of patellar fracture in which the patella is extra-articularly avulsed by the patellar tendon. Such fractures account for 5 to 22.4% of all patellar fractures [1, 2] and are usually comminuted [3].
The apex is the most inferior (lowest) part of the patella. It is pointed in shape, and gives attachment to the patellar ligament. The front and back surfaces are joined by a thin margin and towards centre by a thicker margin.
Abstract. 1. Attention is called to typical longitudinal fracture of the patella in a vertical sagittal plane, usually over the junction of the outer and middle quarters of the patella. 2. This fracture is not as uncommon as is usually believed, but is rarely recognized.
Overview. The patellofemoral (kneecap) joint is made up of two bones: the patella (the kneecap) and the femur (the thighbone). When the knee bends and straightens, the patella glides along a groove on the femur called the trochlea. Some people have differences in the way the kneecap and this bone fit together.
sesamoid boneThe patella is the largest sesamoid bone in the human body and is located anterior to knee joint within the tendon of the quadriceps femoris muscle, providing an attachment point for both the quadriceps tendon and the patellar ligament.
Displaced fractures will likely require surgery because the bones are unstable while nondisplaced fractures normally only need to be immobilized in a cast for six weeks to properly heal. Both treatment options require physical therapy to regain strength and full range of motion, and prevent joint stiffness.
A nondisplaced fracture is one in which the bone cracks or breaks but retains its proper alignment. Nondisplaced fractures often require only bracing, booting or casting treatment.
A patellar fracture is a serious injury that can make it difficult or even impossible to straighten your knee or walk. Some simple patellar fractures can be treated by wearing a cast or splint until the bone heals. In most patellar fractures, however, the pieces of bone move out of place when the injury occurs.
If the bone has healed, you may be able to start walking without crutches. Physical therapy continues for another two to four weeks after that, or until the patella has healed enough that you don't experience pain during low-impact physical activities.
Now, let’s address coding open knee procedures, as well as non-operative services, including injections and fracture care.#N#Open Procedures#N#There is a wide range of CPT® codes (27301-27599) that covers the gamut of open knee services, such as incision, excision, repair/revision/reconstruction, fracture/dislocation treatment, etc.#N#Manipulation of the knee joint 27570 Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) usually is bundled into a surgical procedure, and is rarely paid unless it’s done alone.#N#Because of the anticipated recovery time of a few days, total knee arthroplasty (TKA), 27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) is an inpatient procedure (POS 21). The most common diagnosis to justify a TKA is severe osteoarthritis (ICD-10 M17.- or ICD-9 715.26/715.36).#N#Know the Lingo#N#To verify TKA procedural notes, watch for words such as medial, lateral, patellofemoral, and tibial. Progress notes should confirm the osteoarthritis is so severe there is bone-on-bone encroachment. (Payers may want to see a copy of the dictated notes.)#N#For a TKA revision (27486 Revision of total knee arthroplasty, with or without allograft; 1 component and 27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component ), watch for key words such as “removal and replacement of polyetheline liner” or “poly exchange,” and determine whether both the femoral and tibial components were removed. If only the liner was removed and replaced, report 27486 with modifier 52 Reduced services.#N#Don’t Get Tripped Up By Common Errors#N#A common error is failing to document or code a tendon transfer, which can be reported separately with 27396 Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon. The tendon repair codes also can easily be confused with 27437 Arthroplasty, patella; without prosthesis, which refers to a bone/joint repair rather than a tendon repair. This is a classic example of how important it is to read the entire report and to understand exactly what type of tissue is being repaired, as well as to account for all procedures performed during the operative session (some of which may not be included in a primary procedure and would not trigger National Correct Coding Initiative edits).#N#More Tricks of the Trade
Services to treat early osteoarthritis and other chronic or acute knee conditions include steroid or nonsteroidal anti-inflammatory drug (NSAID) injections, and various non-operative fracture treatments. These are just temporary alternatives to surgery.
In this case, the correct CPT® code for the initial treatment is 27750 Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation.#N#If you were to use the diagnosis presentation term “open tibial shaft fracture” for CPT® code selection, however, you would inappropriately select 27758 Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage.
An open fracture means that a fracture fragment has pierced the skin, exposing the fractured bone to air. Providers might use phrases like “puncture site” or “open wound down to the fracture site” to reference an open fracture. Conversely, a closed fracture does not produce an open wound at the fracture site, and the fractured bone is not exposed ...
The application of the cast is inherent to the fracture treatment procedure code. If, however, the provider subsequently applies or replaces the cast during a follow-up encounter, report the procedure code for casting.
Closed treatment without manipulation involves the use of medical supplies to stabilize the fracture site while it heals or to support weight-bearing during the healing period. Supplies used in closed treatment without manipulation include casts, splints, slings, walking boots, braces, and crutches.
Fractures are common but coding them isn’t always easy. Correct coding relies on you knowing how to identify both the presentation and treatment of the fracture.#N#To differentiate between the type of fracture and the type of treatment provided: