AHA Coding Clinic® for ICD-9 - 2010 Issue 2; Ask the Editor
Impending Pathological Fracture Due to Multiple Myeloma
The patient is a 46-year-old man with multiple myeloma who was admitted to the hospital for management of pathologic fracture of the proximal shaft of the humerus. He also has impending pathologic fractures in multiple places of his left femur, which are very painful. CT scan of the femur demonstrated significant thinning of the medial wall, multiple cortical permeative changes involving the femur neck and permeative changes of the ischium. The patient is unable to bear weight; therefore the decision was made to undergo prophylactic cephalomedullary trochanteric nail fixation of the left femur as well as intramedullary nail fixation of the right humerus. How should this case be coded? ...
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Article Overview
This premium article discusses coding for a complex inpatient case involving multiple myeloma, pathologic fracture, and impending fracture management. It is aimed at coders and billing professionals who work with hospital diagnoses and musculoskeletal procedures and need to understand the relevant diagnosis and procedure code categories involved in the case.
Why This Topic Matters
Accurate code assignment in cases involving malignancy-related fractures can affect diagnosis sequencing, procedure reporting, and compliance with inpatient coding requirements.
What You Will Learn
- How the case is framed for diagnosis coding
- How the related fracture and malignancy categories are presented
- What procedure coding topics are implicated by the case
- How inpatient coding context affects case review
Who Should Read This
- Inpatient coders
- Hospital billing staff
- Coding auditors
- Revenue cycle professionals
Codes Discussed
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