Understanding Right Fibula Fracture diagnosis, medical coding, and clinical documentation. Find information on Fracture of Right Fibula, Right Fibular Fracture, Right Leg Fracture, and Fracture of Right Lower Leg including symptoms, treatment, and ICD-10 coding guidelines for accurate healthcare documentation. This resource offers essential details for physicians, coders, and other healthcare professionals dealing with fibular fractures.
Also known as
Fracture of right fibula
Covers fractures of the right fibula at different levels.
Fracture of fibula alone
Includes fractures of the fibula, right or left, without tibial involvement.
Fracture of lower leg
Encompasses fractures of the tibia, fibula, or both.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the fracture open or closed?
Open
Type of open fracture?
Closed
Specific site?
When to use each related code
| Description |
|---|
| Right fibula fracture |
| Right tibia fracture |
| Right ankle fracture |
Coding requires specific right or left designation. Documentation must clearly identify laterality to avoid coding errors and claim denials.
Fibula fractures require specific site documentation (e.g., proximal, distal, shaft) for accurate coding and appropriate reimbursement.
Using unspecified fracture codes when more specific documentation is available can lead to downcoding and lost revenue. CDI can improve documentation.
Q: What are the best evidence-based conservative management strategies for a stable, non-displaced fracture of the right fibula in adults?
A: For stable, non-displaced right fibular fractures in adults, conservative management is often the first line of treatment. Weight-bearing status depends on pain tolerance, but protected weight-bearing with crutches or a brace is typically recommended initially. Immobilization with a below-knee cast, boot, or splint can provide stability and pain relief. Regular clinical and radiographic follow-up is essential to monitor healing progress and ensure appropriate callus formation. Pain management can involve analgesics, NSAIDs, and elevation. Early mobilization with range-of-motion exercises and physical therapy is crucial to prevent stiffness and restore function. Explore how our physical therapy protocols can optimize recovery for right fibular fracture patients.
Q: When is surgical intervention indicated for a right fibular fracture, and what are the key factors influencing that decision?
A: Surgical intervention for a right fibular fracture is generally considered for unstable fractures, including those with significant displacement, comminution, associated injuries (e.g., tibial fracture, ankle dislocation), or involvement of the syndesmosis. Open fractures and fractures that fail to heal with conservative management also warrant surgical consideration. The decision for surgery is based on a combination of factors, including the patient's age, activity level, overall health, and the specific fracture characteristics. Surgical options may include open reduction internal fixation (ORIF) with plates and screws, intramedullary nailing, or external fixation. Consider implementing a standardized clinical pathway for right fibular fracture management to streamline decision-making and improve patient outcomes.
Patient presents with complaints of right lower leg pain following a twisting injury while playing basketball. Onset of pain was acute and localized to the lateral aspect of the right leg. Physical examination reveals tenderness to palpation over the distal third of the right fibula, with associated swelling and ecchymosis. Pain is exacerbated with weight bearing and range of motion. Differential diagnosis includes right fibular fracture, ankle sprain, soft tissue injury, and stress fracture. Radiographic imaging of the right ankle and lower leg was ordered to evaluate for right leg fracture and rule out other bony pathology. X-rays confirm a closed, non-displaced fracture of the distal right fibula. Assessment: Right fibular fracture (ICD-10 code S82.401A). Plan: Conservative management with a short leg walking cast, weight-bearing as tolerated, and close follow-up in two weeks to assess healing progress. Patient education provided regarding cast care, pain management, and activity modification. Referral to orthopedics will be considered if inadequate healing is observed. Medical coding for this encounter will include the appropriate evaluation and management codes along with the specific fracture code. Patient advised to return to the clinic for any worsening pain, numbness, or tingling in the right foot or toes.