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S92.352A
ICD-10-CM
Left 5th Metatarsal Fracture

Find information on Left 5th Metatarsal Fracture diagnosis, including clinical documentation tips, ICD-10 and CPT codes, healthcare guidelines, and medical coding best practices. Learn about Jones fracture, avulsion fracture, stress fracture classifications, radiology coding, and proper documentation for optimal reimbursement. Understand the differences between proximal, diaphyseal, and distal fractures of the 5th metatarsal and explore relevant medical billing and coding resources for accurate claim submission.

Also known as

Fracture of the left fifth metatarsal
Left fifth metatarsal bone fracture

Diagnosis Snapshot

Key Facts
  • Definition : Break in the outermost bone of the foot.
  • Clinical Signs : Pain, swelling, bruising on outer foot, difficulty walking.
  • Common Settings : Trauma, overuse, sports injuries, falls.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S92.352A Coding
S92.2

Fracture of fifth metatarsal

Covers fractures of the left or right fifth metatarsal bone.

S92

Fracture of foot and toe

Includes various fractures of the foot and toes, except the ankle.

S00-T98

Injury, poisoning and certain other consequences of external causes

Encompasses a wide range of injuries, including fractures, due to external causes.

Code-Specific Guidance

Decision Tree for

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

Is the fracture of the proximal phalanx of the left fifth toe?

  • Yes

    Code S92.442A Fracture of the proximal phalanx of left little toe, initial encounter

  • No

    Is the fracture of the left fifth metatarsal?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Left 5th Metatarsal Fracture
Left Foot Stress Fracture
Left Foot Sprain or Strain

Documentation Best Practices

Documentation Checklist
  • Document fracture type (avulsion, Jones, stress)
  • Laterality (left 5th metatarsal)
  • Precise location of fracture
  • Mechanism of injury (traumatic, stress)
  • Associated injuries (ankle, foot)

Coding and Audit Risks

Common Risks
  • Laterality Coding Error

    Incorrectly coding the affected side (left vs. right) leading to claim rejections or inaccurate data reporting. Impacts reimbursement and quality metrics.

  • Fracture Specificity Lack

    Failing to document the precise fracture type (e.g., Jones, avulsion, stress) can affect coding accuracy and reimbursement.

  • Associated Injury Omission

    Overlooking additional injuries (e.g., soft tissue damage, dislocations) impacts appropriate coding and complete clinical picture.

Mitigation Tips

Best Practices
  • Document fracture type: avulsion, Jones, stress. ICD-10 S92.242A
  • X-ray: AP, lateral, oblique views. Precise location crucial for CDI
  • Assess Ottawa Ankle Rules for potential ankle injury. SNOMED CT 248511001
  • Weight-bearing status, pain management plan. Improve documentation specificity
  • Query physician for complete fracture description. Ensure compliant coding

Clinical Decision Support

Checklist
  • 1. Palpate 5th metatarsal for tenderness (ICD-10 S92.4)
  • 2. Assess for edema/ecchymosis at lateral foot (CPT 73620)
  • 3. Evaluate for pain with weight-bearing (patient safety)
  • 4. Obtain X-ray: foot, lateral view (SNOMED CT 409077006)

Reimbursement and Quality Metrics

Impact Summary
  • Left 5th Metatarsal Fracture reimbursement impacts ICD-10 S92.4, CPT 28470, 28472. Accurate coding maximizes payment.
  • Quality metrics: Fracture care time, pain management, post-op complications, return to function impact hospital quality reporting.
  • Coding accuracy crucial for proper DRG assignment impacting MS-DRG reimbursement for Left 5th Metatarsal Fracture.
  • Optimize billing: Timely claim submission, correct modifiers, documentation specificity improve Left 5th Metatarsal Fracture payments.

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.

Quick Tips

Practical Coding Tips
  • ICD-10 S92.24XA, left foot
  • Specify laterality: left
  • Document fracture type
  • Confirm diagnosis with imaging
  • Check 7th character for initial/subsequent

Documentation Templates

Patient presents with complaints of left foot pain following a (mechanism of injury, e.g., twisting injury, direct blow).  Pain is localized to the lateral aspect of the left foot over the fifth metatarsal.  Onset of pain was (acute or insidious).  Patient reports (presence or absence of) weight-bearing difficulties, edema, ecchymosis, and antalgic gait.  Physical examination reveals tenderness to palpation over the fifth metatarsal, specifically at the (location of fracture, e.g., distal diaphysis, proximal diaphysis, tuberosity, Jones fracture).  Range of motion of the left foot and ankle is (limited or within normal limits) with pain elicited on (specific movements, e.g., inversion, eversion, plantarflexion).  Neurovascular examination of the left foot is intact.  Radiographic imaging of the left foot (X-ray, CT scan if performed) confirms a fracture of the left fifth metatarsal, classified as (e.g., avulsion fracture, stress fracture, Jones fracture) with (description of fracture, e.g., displacement, comminution, angulation).  Assessment:  Left fifth metatarsal fracture.  Differential diagnoses considered include soft tissue injury, sprain, and tendonitis.  Plan:  Patient education provided regarding fifth metatarsal fracture care, including RICE (rest, ice, compression, elevation).  Weight-bearing status is (non-weight-bearing, partial weight-bearing, weight-bearing as tolerated) with assistive device (crutches, walking boot, etc.) as needed.  Pain management with (analgesics prescribed, e.g., ibuprofen, acetaminophen).  Referral to orthopedics for definitive management and consideration of (casting, surgical intervention) if indicated.  Follow-up scheduled in (duration) for reassessment and monitoring of fracture healing.  ICD-10 code (e.g., S92.402A) and CPT codes (e.g., for initial visit, radiographic interpretation, application of splint or cast, if performed) assigned.