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S52.91XA
ICD-10-CM
Right Elbow Fracture

Find information on Right Elbow Fracture diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about ICD-10 codes for Right Elbow Fracture, diagnosis criteria, treatment options, and best practices for accurate medical record keeping. Explore relevant medical terminology and coding guidelines for proximal radius fracture, distal humerus fracture, olecranon fracture, radial head fracture, and other related elbow injuries. This resource supports healthcare professionals in accurate coding and documentation for optimal patient care and billing.

Also known as

Fracture of Right Elbow
Right Humerus Fracture

Diagnosis Snapshot

Key Facts
  • Definition : Break in one or more bones of the elbow joint.
  • Clinical Signs : Pain, swelling, bruising, limited range of motion, deformity.
  • Common Settings : Falls, sports injuries, direct trauma to the elbow.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S52.91XA Coding
S52.00-S52.99

Fracture of forearm

Includes fractures of the right or left radius, ulna, or both near the elbow.

S42.00-S42.99

Fracture of upper arm

Includes fractures of the humerus, which may indirectly affect elbow function.

M70-M79

Soft tissue disorders

May involve elbow soft tissues as a complication or concurrent injury with fracture.

T84.0-T84.9

Complications of surgical procedures

May include complications related to elbow fracture repair surgery.

Code-Specific Guidance

Decision Tree for

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 of fracture?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Right Elbow Fracture
Right Radial Head Fracture
Right Olecranon Fracture

Documentation Best Practices

Documentation Checklist
  • ICD-10 S42, right elbow fracture diagnosis code
  • Laterality: Specify right elbow involvement
  • Fracture type: e.g., displaced, open, comminuted
  • Associated injuries: Document any soft tissue damage
  • Imaging confirmation: X-ray, CT, MRI findings

Coding and Audit Risks

Common Risks
  • Unspecified Fracture

    Coding with unspecified fracture codes (e.g., S52.9) when documentation supports a more specific type (e.g., displaced, open). Impacts reimbursement and data accuracy.

  • Laterality Issues

    Missing or incorrect laterality (right vs. left) can lead to inaccurate coding, affecting claims processing and quality reporting.

  • Associated Injuries

    Failure to code associated injuries (e.g., nerve damage, open wound) with the right elbow fracture. Impacts severity measures and reimbursement.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (S42, S52) for elbow fracture type.
  • Detailed documentation of fracture displacement, laterality, mechanism.
  • X-ray confirmation, precise anatomical location description for CDI.
  • Timely orthopedic consult, follow-up documentation for compliance.
  • Monitor for compartment syndrome, document neurovascular status.

Clinical Decision Support

Checklist
  • Verify mechanism of injury documented (FOOSH, direct blow)
  • Confirm imaging confirms fracture (X-ray, CT)
  • Assess neurovascular status (radial pulse, sensation)
  • Document fracture type and location (ICD-10 S52, S52.0)
  • Evaluate need for reduction/immobilization/referral

Reimbursement and Quality Metrics

Impact Summary
  • Right Elbow Fracture Reimbursement: Coding accuracy impacts payment. Proper ICD-10 (S92) and CPT codes crucial for maximizing reimbursement.
  • Quality Metrics Impact: Accurate fracture documentation affects hospital quality scores. Reporting timeliness influences performance metrics.
  • Coding Accuracy: Correctly coding laterality, fracture type, and associated injuries ensures proper DRG assignment and claim processing.
  • Hospital Reporting: Accurate diagnosis coding improves data integrity for public health reporting and internal quality improvement initiatives.

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.

Frequently Asked Questions

Common Questions and Answers

Q: What are the key clinical findings for differentiating between a radial head fracture and a distal humerus fracture in an adult patient presenting with right elbow pain after a fall?

A: Differentiating between a radial head fracture and a distal humerus fracture relies on a combination of clinical findings, mechanism of injury, and imaging. In a patient with right elbow pain post-fall, careful palpation is crucial. Radial head fractures often present with localized tenderness over the radial head, limited supination/pronation, and possible palpable crepitus. Distal humerus fractures, particularly supracondylar fractures, may exhibit tenderness more posteriorly, with potential swelling and deformity around the elbow joint, and possible neurovascular compromise. Mechanism of injury, such as a fall on an outstretched hand, is more suggestive of a radial head fracture while a direct blow to the elbow may indicate a distal humerus fracture. Radiographic imaging, including AP, lateral, and oblique views of the elbow, is ultimately necessary to confirm the diagnosis and classify the fracture. Explore how advanced imaging modalities like CT scans can further characterize complex fractures.

Q: How do I manage a non-displaced right radial head fracture conservatively, and when is surgical intervention indicated for this type of elbow fracture?

A: Non-displaced radial head fractures are often managed conservatively with initial immobilization in a sling or posterior splint for pain control and to promote healing. Early mobilization, within a few days, is key to preventing stiffness and restoring function. Gentle range-of-motion exercises are gradually introduced and progressed as tolerated by the patient. Surgical intervention is generally indicated for displaced fractures, mechanical block to motion, or complex fractures involving associated ligamentous injuries. Factors like fracture displacement exceeding 2 mm, involvement of more than 30% of the articular surface, or the presence of an Essex-Lopresti lesion necessitate surgical management. Consider implementing a structured rehabilitation program post-injury to optimize patient outcomes.

Quick Tips

Practical Coding Tips
  • Code specific fracture site
  • Document fracture type
  • Laterality is key
  • ICD-10 S00-S99
  • 7th character crucial

Documentation Templates

Patient presents with complaints of right elbow pain, swelling, and limited range of motion following a fall onto an outstretched hand.  Onset of symptoms occurred approximately two hours prior to presentation.  Physical examination reveals tenderness to palpation over the lateral epicondyle and olecranon process.  Ecchymosis and edema are noted around the elbow joint.  Range of motion is restricted due to pain, with notable difficulty in flexion, extension, pronation, and supination.  Neurovascular assessment reveals intact radial, ulnar, and median nerve function with palpable distal pulses.  Radiographic imaging of the right elbow demonstrates a displaced fracture of the radial head, consistent with a Mason Type II radial head fracture.  Diagnosis of right elbow fracture radial head is confirmed.  Treatment plan includes closed reduction and immobilization with a long arm posterior splint.  Patient is advised on pain management with NSAIDs and ice.  Referral to orthopedics for further evaluation and management is scheduled.  Patient education provided regarding fracture care, activity restrictions, and follow-up appointments.  ICD-10 code S92.101A, unspecified fracture of upper end of right radius, initial encounter for closed fracture.  CPT codes for evaluation and management, radiographic imaging, and splinting will be appended based on services rendered.  Prognosis is good with appropriate treatment and adherence to the recommended care plan.