Periprosthetic fractures occur in patients who have undergone joint replacement surgery, and can be a complex condition to code in ICD-10. Here’s a guide on how to code periprosthetic fractures in ICD-10:
- Identify the site of the fracture: Periprosthetic fractures can occur in various sites, including the femur, tibia, and hip. The location of the fracture will determine the specific code to use.
- Determine the type of fracture: There are several types of periprosthetic fractures, including type I, type II, and type III fractures. Type I fractures involve the bone around the implant, type II fractures involve the bone within the implant, and type III fractures involve both the bone around and within the implant.
- Use the appropriate ICD-10 code: Once you have identified the site and type of fracture, use the appropriate ICD-10 code to report the condition. Some common codes for periprosthetic fractures include:
- S72.404A – Periprosthetic fracture around internal prosthetic left hip joint, initial encounter for closed fracture
- S82.872A – Periprosthetic fracture around internal prosthetic right knee joint, initial encounter for closed fracture
- M97.01XA – Periprosthetic fracture around internal left ankle prosthesis, initial encounter
- Use additional codes when necessary: In some cases, additional codes may be necessary to provide a more detailed description of the patient’s condition or to identify any complications.
- Follow sequencing rules: When reporting periprosthetic fractures along with other conditions, follow the sequencing rules to ensure that the primary reason for the encounter is listed first.
Remember, accurate coding is essential for proper reimbursement and patient care. Take the time to understand the ICD-10 codes for periprosthetic fractures and use the coding guidelines to guide your coding decisions.