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S82.309A
ICD-10-CM
Distal Tibia Fracture

Understanding Distal Tibia Fracture diagnosis, including Pilon Fracture and Tibial Plafond Fracture, is crucial for accurate clinical documentation and medical coding. This page provides information on Distal Tibial Shaft Fracture diagnosis, treatment, and ICD-10 coding guidelines for healthcare professionals. Learn about the different types of distal tibia fractures and best practices for documenting these injuries in medical records.

Also known as

Pilon Fracture
Distal Tibial Shaft Fracture
Tibial Plafond Fracture

Diagnosis Snapshot

Key Facts
  • Definition : Break in the lower part of the shinbone (tibia), often involving the ankle joint.
  • Clinical Signs : Pain, swelling, deformity, inability to bear weight, bruising, tenderness to touch.
  • Common Settings : High-energy trauma (falls, car accidents), sports injuries, osteoporosis-related fractures.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S82.309A Coding
S82.4-

Fracture of lower end of tibia

This code range covers fractures of the distal tibia, including pilon and plafond fractures.

S82.-

Fracture of tibia and fibula

This includes fractures involving both the tibia and fibula at any level.

S02.7-

Fracture of skull and facial bones

While unlikely related to a tibia fracture, this is included to demonstrate code format for multiple areas. Use only if clinically relevant.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the fracture open or closed?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Fracture of the distal tibia.
Fracture involving the ankle joint and distal tibia.
Fracture of the tibial shaft, excluding the proximal and distal ends.

Documentation Best Practices

Documentation Checklist
  • Document fracture location (distal tibia).
  • Specify fracture type (eg, comminuted, displaced).
  • Describe any associated fibular fracture.
  • Note mechanism of injury (MOI).
  • Document treatment plan (e.g., surgical, nonsurgical).

Coding and Audit Risks

Common Risks
  • Specificity of Fracture

    Coding requires specifying if the fracture is open or closed, displaced or non-displaced, and the precise location within the distal tibia (medial, lateral, posterior malleolus).

  • Pilon vs. Plafond

    Incorrectly coding a pilon fracture as a plafond fracture or vice-versa. Both involve distal tibia but represent different injury patterns and severity, impacting reimbursement.

  • Associated Injuries

    Overlooking associated fibular fractures, ligamentous injuries, or intra-articular involvement can lead to undercoding and lost revenue. Thorough documentation is crucial.

Mitigation Tips

Best Practices
  • Document fracture type, location, and displacement for accurate ICD-10 and CPT coding.
  • Capture mechanism of injury details for improved risk adjustment and HCC coding.
  • Assess and document neurovascular status for complete clinical picture and compliant billing.
  • Order appropriate imaging studies (X-ray, CT) and document findings for medical necessity.
  • Ensure timely orthopedic consultation documentation for care coordination and optimal reimbursement.

Clinical Decision Support

Checklist
  • Verify mechanism of injury (high-energy trauma, fall, etc.) documented
  • Confirm radiographic imaging (X-ray, CT) confirms distal tibia fracture location
  • Assess for associated fibular fracture and soft tissue injury
  • Evaluate neurovascular status of affected limb documented

Reimbursement and Quality Metrics

Impact Summary
  • **Reimbursement and Quality Metrics Impact Summary for Distal Tibia Fracture (ICD-10-CM D code):**
  • ICD-10-CM code accuracy impacts distal tibia fracture reimbursement.
  • Proper coding ensures correct DRG assignment for optimal payment.
  • Accurate documentation and coding improve hospital quality reporting.
  • Coding quality affects physician profiling and value-based care metrics.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the key clinical indicators differentiating a distal tibia fracture from a tibial plafond fracture or a distal tibial shaft fracture?

A: While the terms are often used interchangeably, subtle distinctions exist. A distal tibia fracture refers to any break in the lower part of the tibia. A tibial plafond fracture specifically involves the articular surface of the distal tibia (the weight-bearing part), often with significant comminution and soft tissue involvement. A distal tibial shaft fracture occurs higher up the tibial shaft, further away from the ankle joint. Key differentiating factors include the fracture location relative to the ankle joint, the degree of articular involvement, and the mechanism of injury. Precise classification requires thorough clinical examination, including careful palpation for tenderness, assessment of neurovascular status, and weight-bearing ability, combined with radiographic imaging. Explore how advanced imaging modalities like CT and MRI can further delineate fracture complexity and inform surgical planning.

Q: How do I choose the most appropriate surgical management strategy for a complex distal tibia fracture with articular involvement, considering factors like soft tissue injury and patient comorbidities?

A: Managing complex distal tibia fractures requires a nuanced approach that balances restoring articular congruity with preserving soft tissue integrity. Factors like the degree of comminution, articular surface displacement, associated fibular fractures, open wounds, and patient factors such as age, bone quality, and comorbidities play a crucial role in decision-making. Surgical options range from open reduction internal fixation (ORIF) with plates and screws, external fixation for severe soft tissue compromise, or even staged procedures involving initial external fixation followed by definitive ORIF once soft tissue conditions improve. Consider implementing a multidisciplinary approach involving orthopedic trauma surgeons, plastic surgeons, and infectious disease specialists to optimize outcomes in complex cases. Learn more about the latest advancements in surgical techniques and implants for distal tibia fractures.

Quick Tips

Practical Coding Tips
  • ICD-10 S82.4 code for distal tibia
  • Document fracture specifics for Pilon
  • Specify if intra/extra-articular
  • Add laterality (left/right tibia)
  • Check documentation for plafond

Documentation Templates

Patient presents with complaints consistent with a distal tibia fracture, also known as a pilon fracture or tibial plafond fracture.  Onset of symptoms followed [Mechanism of Injury - e.g., fall from height, motor vehicle accident].  Patient reports pain, swelling, and ecchymosis at the distal tibia.  [Describe location and severity of pain - e.g., localized to the ankle, radiating to the foot, severe, moderate, mild].  Palpation reveals tenderness over the distal tibia and fibula.  [Describe any deformity or crepitus].  Neurovascular assessment of the affected extremity reveals [Describe sensory and motor function, pulses - e.g., intact, diminished, absent].  Range of motion is limited due to pain and swelling.  Radiographic imaging of the distal tibia and ankle [Specify imaging modality - e.g., X-ray, CT scan] demonstrates a [Describe fracture characteristics - e.g., comminuted, displaced, intra-articular] fracture of the distal tibia involving [Specify anatomical location - e.g., medial malleolus, lateral malleolus, posterior malleolus, tibial plafond].  Assessment includes evaluation for associated injuries, including fibular fracture, ligamentous injury, and soft tissue compromise.  Differential diagnosis includes ankle sprain, fibular fracture, and talar fracture.  Impression is distal tibia fracture (ICD-10 code S82.6).  Plan includes [Outline treatment plan - e.g., pain management with analgesics, immobilization with splint or cast, orthopedic consultation for surgical management, elevation and ice therapy].  Patient education provided regarding fracture care, weight-bearing status, and follow-up appointments.  Return to clinic scheduled in [Timeframe - e.g., one week] for reassessment and further management.