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S92.001A
ICD-10-CM
Right Calcaneal Fracture

Find information on right calcaneal fracture diagnosis, including ICD-10 codes S92.0 and S92.1, clinical documentation requirements, heel bone fracture treatment, and post-operative care. Learn about calcaneus fracture diagnosis coding, radiology, and medical billing guidelines for accurate healthcare claim submission. Explore resources for physicians, coders, and healthcare professionals managing calcaneal fractures.

Also known as

Right Heel Fracture
Fracture of Right Calcaneus

Diagnosis Snapshot

Key Facts
  • Definition : Break in the heel bone.
  • Clinical Signs : Heel pain, swelling, bruising, difficulty walking.
  • Common Settings : Falls, sports injuries, motor vehicle accidents.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S92.001A Coding
S92.0-

Fracture of calcaneus

Covers fractures of the calcaneus (heel bone).

S90-S99

Injuries to the ankle and foot

Includes various injuries like sprains, strains, and fractures.

S00-T98

Injuries, poisonings, etc.

Encompasses a broad range of external causes of injury.

Code-Specific Guidance

Decision Tree for

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

Is the fracture displaced?

  • Yes

    Intra-articular?

  • No

    Intra-articular?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Right Calcaneal Fracture
Left Calcaneal Fracture
Calcaneal Stress Fracture

Documentation Best Practices

Documentation Checklist
  • ICD-10 S92.0 Calcaneal fracture, right
  • Laterality: Right calcaneus specified
  • Fracture type: Displaced, nondisplaced, open, closed
  • Mechanism of injury documented
  • Associated injuries: Soft tissue, other fractures

Coding and Audit Risks

Common Risks
  • Laterality Coding Error

    Incorrectly coding the left vs. right calcaneus, leading to claim denials or inaccurate data reporting. Focus on documentation clarity.

  • Specificity of Fracture

    Lack of documentation specifying the fracture type (e.g., displaced, intra-articular). Impacts reimbursement and quality metrics. CDI crucial.

  • Associated Injuries Coding

    Failure to capture additional injuries (e.g., soft tissue damage, other fractures) present with the calcaneal fracture. Affects severity and reimbursement.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding: S02.201A-S02.209A. Verify laterality.
  • Thorough documentation of fracture type, location, mechanism for optimal reimbursement.
  • Image guidance for closed reduction improves alignment. Document technique.
  • Surgical intervention when necessary. Clear documentation of hardware, approach.
  • Timely follow-up, PT consults for functional recovery. Monitor & document progress.

Clinical Decision Support

Checklist
  • Hx: Fall, direct blow, or twisting injury to heel
  • PE: Pain, swelling, ecchymosis, tenderness over calcaneus
  • Imaging: X-ray foot (lateral, axial views) to confirm fracture
  • Assess neurovascular status of foot and ankle
  • Consider CT if fracture complexity is unclear on x-ray

Reimbursement and Quality Metrics

Impact Summary
  • Right Calcaneal Fracture Reimbursement: Coding accuracy impacts physician payments and claim denials. Focus on ICD-10 S92.0-S92.9 and CPT 27780-27824 for optimal reimbursement.
  • Quality Metrics Impact: Calcaneal fracture treatment quality affects patient outcomes. Monitor surgical site infection (SSI) rates and functional recovery.
  • Hospital Reporting: Accurate fracture coding improves data for hospital quality reporting. Affects public rankings and value-based payments.
  • Calcaneal Fracture Coding: Proper ICD-10 and CPT coding ensures appropriate DRG assignment and accurate hospital reimbursement.

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 S92.0 Calcaneus fx
  • Specify laterality: RIGHT
  • Document fracture type
  • Query physician for details
  • 7th character for encounter

Documentation Templates

Patient presents with complaints of right heel pain following a fall or injury.  Onset of pain was (acute or insidious) and is described as (sharp, dull, aching, throbbing).  Pain is exacerbated by weight-bearing and ambulation.  Patient reports (difficulty walking, inability to bear weight, limping).  Associated symptoms may include swelling, bruising, and tenderness to palpation over the right calcaneus.  Mechanism of injury reported as (fall from height, twisting injury, direct impact).  Physical examination reveals (edema, ecchymosis, point tenderness) over the right heel.  Range of motion of the right ankle and foot is (limited, normal) with pain noted on (inversion, eversion, plantarflexion, dorsiflexion).  Neurovascular assessment of the right foot is intact.  Radiographic imaging of the right foot and ankle (X-ray, CT scan) demonstrates a fracture of the calcaneus, classified as (intra-articular, extra-articular) with (comminution, displacement) noted.  Differential diagnosis includes calcaneal contusion, Achilles tendon rupture, and ankle sprain.  Assessment:  Closed fracture of the right calcaneus.  Plan:  Conservative management with (rest, ice, compression, elevation), immobilization with a (boot, splint, cast), pain management with (NSAIDs, analgesics), and referral to orthopedics for definitive treatment.  Follow-up scheduled in (number) weeks for reevaluation and discussion of further management options, including surgical intervention if indicated.  Patient education provided on fracture care, weight-bearing restrictions, and potential complications such as post-traumatic arthritis.  ICD-10 code S92.0xxA assigned.
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