Health Information Management

Tip: Note increased specificity for injuries to shoulder bones in ICD-10-CM

APCs Insider, October 19, 2012

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ICD-10-CM codes for injuries to the bones of the shoulder require seven characters, and coders will select a code based on the specific injury. For example, if a patient suffers a dislocation of the humerus, coders have the following categories of codes to choose from:

  • S43.01, anterior subluxation and dislocation of humerus
  • S43.02, posterior subluxation and dislocation of humerus
  • S43.03, inferior subluxation and dislocation of humerus
Each code requires a sixth character to denote ­laterality and a seventh character for the encounter. So if the physician documents an initial visit for a ­posterior subluxation of right humerus, coders would report S43.021A.
 
If a patient suffers a fractured scapula, coders need to know whether the fracture is displaced or non-displaced, as well as the specific site of the fracture. For a fracture of the scapula, coders would choose the appropriate code from the following:
  • S42.11, fracture of body of scapula
  • S42.12, fracture of acromial process
  • S42.13, fracture of coracoid process
  • S42.14, fracture of glenoid cavity of scapula
  • S42.15, fracture of neck of scapula
  • S42.19, fracture of other part of scapula
The sixth and seventh characters provide additional information. If the patient is seen for a subsequent visit for a displaced fracture of neck of scapula of the left shoulder, coders would report S42.152D.
 
The tip is adapted from “ICD-10 anatomy refresher: Shoulder” in the October Briefings on APCs.



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