Health Information Management

Tip: Learn new ICD-10-CM documentation requirements for pathologic fractures

APCs Insider, July 15, 2011

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A pathologic fracture is a broken bone caused by disease. ICD-10-CM expands code selection for this types of fracture to more than 150 codes. In ICD-9-CM, coders may select from only eight codes.

With the advent of ICD-10, pathologic fracture documentation and coding will need to include:

  • Exact location of fracture
    • Site
    • Laterality
  • Etiology of fracture
    • Osteoporosis
    • Neoplastic disease
  • Encounter type
    • Initial encounter
    • Subsequent encounter
    • Subsequent encounter with delayed healing

If a patient has osteoporosis and a fracture without a fall, the fracture is often assumed to be pathologic.

The tip is adapted from “ICD-10-CM prep: Determine documentation trouble spots” in the June issue of Briefings on APCs.



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