Find information on periprosthetic fracture diagnosis, including clinical documentation requirements, ICD-10 codes (M97.0, M96.6, S72, S42, etc.), CPT codes for surgical treatment, and healthcare guidelines. Learn about periprosthetic femoral fracture, periprosthetic tibial fracture, and periprosthetic humeral fracture classifications, as well as postoperative complications and best practices for medical coding and billing. This resource provides comprehensive information for healthcare professionals on managing and documenting periprosthetic fractures.
Also known as
Periprosthetic fracture
Fracture around a joint replacement.
Fracture of skull and facial bones
Fractures involving skull or facial bones, sometimes periprosthetic.
Fracture of femur
Femur fractures, including those around hip replacements.
Fracture of lower leg
Lower leg fractures, which may occur near knee replacements.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the fracture periprosthetic?
Yes
Is it of the femur?
No
Do NOT code as periprosthetic fracture. Code the appropriate fracture.
When to use each related code
| Description |
|---|
| Periprosthetic Fracture |
| Periprosthetic Joint Infection |
| Aseptic Loosening of Prosthesis |
Coding periprosthetic fracture without specifying anatomical location (e.g., femur, tibia) leads to inaccurate claims and clinical data.
Misclassifying intraoperative fractures as postoperative periprosthetic fractures affects quality metrics and reimbursement.
Failure to document laterality (left or right) for periprosthetic fracture impacts data analysis and claims processing.
Patient presents with complaints consistent with periprosthetic fracture. Symptoms include pain, swelling, and potentially decreased mobility around a previously implanted prosthesis. Onset of symptoms occurred [Date of onset] following [Mechanism of injury, e.g., fall from standing height, twisting injury]. Patient has a history of [Type of arthroplasty, e.g., total hip arthroplasty, total knee arthroplasty] performed on [Date of surgery]. Physical examination reveals [Specific findings, e.g., tenderness to palpation around the prosthesis, ecchymosis, crepitus, deformity, limited range of motion]. Radiographic imaging, including [Type of imaging, e.g., X-ray, CT scan], demonstrates a periprosthetic fracture of the [Bone, e.g., femur, tibia] classified as [Vancouver classification, e.g., Type A, Type B, Type C] involving the [Location, e.g., proximal femur, distal femur]. Differential diagnosis includes loosening of the prosthesis, infection, and soft tissue injury. Assessment includes periprosthetic fracture, [ICD-10 code, e.g., H90.0-, T84.0-]. Plan includes [Treatment plan, e.g., pain management with analgesics, consultation with orthopedics, surgical intervention, non-surgical management]. Patient education provided regarding the diagnosis, treatment options, and potential complications. Follow-up scheduled for [Date of follow-up] to reassess symptoms and discuss further management.