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S92.309A
ICD-10-CM
Metatarsal Fracture

Learn about metatarsal fracture diagnosis, including ICD-10 codes, clinical documentation tips, and healthcare best practices. Find information on metatarsal stress fracture, Jones fracture, metatarsal bone fracture, and other related foot injuries. This resource covers proper medical coding, treatment options, and recovery guidelines for healthcare professionals and patients seeking information on metatarsal fractures.

Also known as

Foot Fracture
Metatarsal Bone Fracture

Diagnosis Snapshot

Key Facts
  • Definition : Break in one or more of the five metatarsal bones of the foot.
  • Clinical Signs : Pain, swelling, bruising, difficulty walking. Tenderness to touch at fracture site.
  • Common Settings : Trauma, overuse, sports injuries, falls. Seen in emergency rooms, clinics, and sports medicine.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S92.309A Coding
S92

Fracture of foot and toes

Covers fractures of metatarsals and other foot bones.

S92.4

Fracture of metatarsal(s)

Specifically designates fractures of one or more metatarsal bones.

S92.5

Fracture of toe(s)

Covers fractures of the phalanges of the toes.

S90-S99

Injuries to the lower limb

Encompasses a broader range of lower limb injuries, including foot fractures.

Code-Specific Guidance

Decision Tree for

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

Is the fracture traumatic?

  • Yes

    Which metatarsal?

  • No

    Stress or Pathologic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Metatarsal Fracture
Metatarsal Stress Fracture
Metatarsalgia

Documentation Best Practices

Documentation Checklist
  • Metatarsal fracture diagnosis code
  • Specific metatarsal bone fractured
  • Fracture type (avulsion, stress, etc.)
  • Laterality (right or left foot)
  • Open or closed fracture documented

Coding and Audit Risks

Common Risks
  • Laterality Coding Errors

    Incorrect or missing laterality (right, left, bilateral) for metatarsal fracture diagnosis codes can lead to claim denials and inaccurate data reporting.

  • Specificity of Fracture

    Failure to specify the precise location and type of metatarsal fracture (e.g., stress, avulsion, Jones) impacts reimbursement and quality metrics.

  • Associated Injury Coding

    Overlooking or undercoding associated injuries (e.g., dislocations, soft tissue damage) with metatarsal fractures can affect DRG assignment and payment.

Mitigation Tips

Best Practices
  • Document fracture location, type, laterality using ICD-10 specificity for accurate coding.
  • Capture precise mechanism of injury details for proper E/M coding and risk adjustment.
  • Query physician for complete documentation of any associated soft tissue injuries.
  • Ensure clear documentation of treatment plan including immobilization, reduction, or surgery.
  • Regularly audit metatarsal fracture documentation for CDI and compliance with payer guidelines.

Clinical Decision Support

Checklist
  • Hx: Direct trauma, twisting injury, or repetitive stress to foot
  • PE: Pain, swelling, deformity, ecchymosis of metatarsal area
  • Imaging: X-ray (weight-bearing if possible) to confirm fracture and location
  • Assess neurovascular status of affected foot

Reimbursement and Quality Metrics

Impact Summary
  • Metatarsal Fracture Reimbursement: Coding accuracy impacts payment. Proper ICD-10 (S92) and CPT (28470-28499) coding crucial for maximizing reimbursement.
  • Quality Metrics Impact: Fracture healing time affects hospital quality scores. Accurate documentation and coding reflect appropriate treatment and improve performance metrics.
  • Coding Accuracy: Correctly coding fracture type, location (ICD-10), and treatment (CPT) ensures appropriate DRG assignment for accurate hospital reimbursement.
  • Hospital Reporting: Precise coding and documentation improve data quality for internal reporting, public health data, and accurate performance benchmarking.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Specify metatarsal(s) fractured
  • Document fracture type/location
  • ICD-10 S92.x, laterality
  • Use 7th character for episode
  • Confirm diagnosis with imaging

Documentation Templates

Patient presents with complaints of metatarsal pain, metatarsalgia, and foot pain following a (mechanism of injury - e.g., twisting injury, fall, direct blow).  Onset of symptoms occurred (timeframe).  Patient localizes pain to the (specific metatarsal, e.g., fifth metatarsal, first metatarsal) region of the (right or left) foot.  Physical exam reveals (tenderness, swelling, ecchymosis, deformity) over the affected area.  Weight-bearing (is or is not) painful.  Range of motion of the affected toe is (limited, normal) with (description of limitation if present).  Neurovascular status of the foot is intact, with palpable dorsalis pedis and posterior tibial pulses.  Radiographic imaging (X-ray, CT scan if obtained) of the foot reveals a (type of fracture - e.g., Jones fracture, stress fracture, avulsion fracture, transverse fracture, comminuted fracture) of the (specific metatarsal).  Diagnosis of metatarsal fracture is confirmed.  Treatment plan includes (conservative management with immobilization, RICE protocol - rest, ice, compression, elevation, surgical intervention, referral to orthopedics, pain management with NSAIDs or other analgesics, follow-up appointment).  Patient education provided regarding metatarsal fracture care, including weight-bearing restrictions, activity modification, and potential complications such as nonunion, malunion, and complex regional pain syndrome.  ICD-10 code (appropriate code based on fracture type and location) applied.