Learn about Femoral Neck Fracture diagnosis, including clinical documentation, medical coding, and treatment. Find information on Hip Fracture and Neck of Femur Fracture (intracapsular fracture) for accurate healthcare coding and documentation best practices. This resource covers key aspects of Femoral Neck Fractures relevant to medical professionals and coders.
Also known as
Fracture of neck of femur
Covers fractures of the femoral neck, including intracapsular and pertrochanteric types.
Pertrochanteric fracture
Fractures involving the trochanteric region of the femur, near the hip joint.
Subtrochanteric fracture
Fractures located in the subtrochanteric region of the femur, below the trochanters.
Osteoporosis with current pathological fracture
Includes osteoporosis if it's a factor in the femoral neck fracture.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the fracture traumatic?
Yes
Is the fracture displaced?
No
Is the fracture pathological?
When to use each related code
| Description |
|---|
| Break in the femur neck. |
| Break in the intertrochanteric region. |
| Break in the proximal femur. |
Missing or incorrect laterality (right, left, unspecified) for femoral neck fracture impacts reimbursement and data accuracy. ICD-10-CM coding guidelines require laterality specification.
Distinguishing between displaced and non-displaced fractures is crucial for accurate ICD-10-CM coding (S72.0- vs S72.1-) and impacts treatment and prognosis documentation.
Failing to identify and code underlying causes like osteoporosis (M80.-) when the fracture is pathological leads to inaccurate coding and quality reporting. Review documentation for etiology.
Q: What are the key clinical features differentiating a femoral neck fracture from an intertrochanteric fracture, and how do these differences inform initial management decisions?
A: Differentiating between femoral neck and intertrochanteric fractures is crucial for determining appropriate management. Femoral neck fractures, also known as intracapsular fractures, typically present with groin pain, shortened and externally rotated leg, and limited range of motion. Intertrochanteric fractures, located extracapsularly, often present with similar external rotation and shortening but may exhibit more pronounced ecchymosis and less severe groin pain. The key differentiator lies in the location of the fracture line relative to the joint capsule. This distinction is critical as femoral neck fractures are at higher risk of nonunion and avascular necrosis due to disruption of the femoral head blood supply. This necessitates prompt assessment of fracture stability and displacement to determine optimal treatment. Stable, nondisplaced femoral neck fractures may be managed with internal fixation (cannulated screws or sliding hip screws). However, displaced fractures often require arthroplasty (hemiarthroplasty or total hip arthroplasty), especially in elderly patients. Intertrochanteric fractures, generally having better blood supply, are usually treated with extramedullary or intramedullary fixation devices. Accurate diagnosis with plain radiographs and potentially CT scans is essential for tailoring management. Explore how different fixation techniques impact patient outcomes in femoral neck fractures.
Q: In geriatric patients with a femoral neck fracture, how do you weigh the risks and benefits of surgical intervention (internal fixation vs. arthroplasty) considering factors such as pre-existing comorbidities and cognitive status?
A: Surgical intervention for femoral neck fractures in geriatric patients presents a complex decision-making process due to the interplay of fracture characteristics, pre-existing comorbidities, and cognitive status. Internal fixation, such as cannulated screws, is generally preferred for younger and more active patients with stable, nondisplaced fractures. However, in elderly patients, particularly those with osteoporosis or pre-existing cognitive impairment, internal fixation carries a higher risk of nonunion, avascular necrosis, and subsequent revision surgery. Arthroplasty, either hemiarthroplasty or total hip arthroplasty, offers the advantage of early mobilization and weight-bearing, which can reduce the risk of complications associated with prolonged immobility, such as pneumonia, deep vein thrombosis, and pressure sores. However, arthroplasty is a more extensive procedure with higher perioperative risks, especially in patients with significant cardiac or pulmonary comorbidities. Cognitive status is a crucial factor, as post-operative delirium and confusion can hinder rehabilitation and functional recovery. Consider implementing a multidisciplinary approach involving geriatricians, orthopedists, anesthesiologists, and physical therapists to individualize surgical decision-making and optimize patient outcomes. Learn more about the latest guidelines for perioperative management of geriatric hip fracture patients.
Patient presents with complaints consistent with a femoral neck fracture, also known as a hip fracture or neck of femur fracture. Onset of symptoms followed a fall from standing height onto the left hip. Patient reports severe pain in the left hip and groin, exacerbated by movement. Unable to bear weight on the affected extremity. Physical examination reveals tenderness to palpation over the left hip, limited range of motion, and ecchymosis. Neurovascular assessment of the left lower extremity reveals palpable dorsalis pedis and posterior tibial pulses. Suspect intracapsular fracture. Ordered radiographs of the left hip and pelvis to confirm diagnosis and assess fracture displacement. Differential diagnosis includes avulsion fracture, stress fracture, and osteoarthritis. Preliminary diagnosis of femoral neck fracture. Plan to consult with orthopedics for surgical management, likely requiring open reduction internal fixation (ORIF) or potential hip replacement depending on fracture classification (Garden classification). Patient education provided on fall prevention, post-operative care, and physical therapy. Will monitor for complications such as avascular necrosis, nonunion, and infection. ICD-10 code S72.00XA assigned for displaced femoral neck fracture, pending radiographic confirmation. CPT codes for anticipated surgical intervention will be determined upon final surgical plan. Continued pain management with analgesics prescribed. Follow-up scheduled for one week post consultation with orthopedics.