tci ED Coding & Reimbursement Alert - 2023 Issue Q3

You Be the Coder: Coding for Stress Fracture

Question: If the encounter notes indicate the patient suffered a stress fracture to their left ankle, should I report standard fracture ICD-10 codes? Or are there specific codes for stress fractures? Missouri Subscriber Answer: You would not use standard fracture codes for stress fractures, as they have their own ICD-10 code set: M84.3- (Stress fracture). For this patient, report M84.372A (Stress fracture, left ankle, initial encounter for fracture). According to ICD-10, providers might refer to stress fractures within the documentation by several other terms, including: Fatigue fracture, March fracture, Stress fracture NOS, or Stress reaction. Just like...

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