# Sesamoid Fracture



## graceroni13 (Nov 23, 2015)

I'm trying to find an ICD-10 code for this and can't find ANYTHING. Does anyone have any suggestions? 


Thank you!


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## graceroni13 (Nov 23, 2015)

in the foot, forgot to mention that haha


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## mhstrauss (Nov 23, 2015)

graceroni13 said:


> in the foot, forgot to mention that haha



Based on this link, and the direction to "code by site under fracture" when looking up Fracture, sesamoid", it looks like you should be using Metatarsal Fracture S93.----. 
I'm not familiar with these, just taking a shot at your question. 

http://www.foothealthfacts.org/footankleinfo/Sesamoid_Injuries.htm


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## kalpana (Nov 23, 2015)

*foot -*

Is it traumatic or pathological fracture.
Foot right or left.


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## graceroni13 (Nov 23, 2015)

It's traumatic, and it's the right foot



Thank you for helping @mhstrauss, i've been talking to the MA and she looked at the list i showed her in the index and she was like "nope nope nope". i just wish there was like an "other specified fracture of foot" all i saw was unspecified. which that drives me nuts, because it IS specified haha not my fault there isn't a code


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## mhstrauss (Nov 23, 2015)

Ha I got that all wrong... I put the wrong code...meant S92.3--but that's not right either! 
I found this too...and I know most don't consider this site an "official resourse", but it's the only other thing I've found. Supports using the unspecified code, unfortunately.
http://www.icd10data.com/ICD10CM/Codes/S00-T88/S90-S99/S92/S92.9-/S92.901A


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## graceroni13 (Nov 23, 2015)

I'll use the unspecified if I HAVE to.... but I just haven't come across this issue before with this code so I wanted to see if anyone else has figured it out, because I guess there wasn't a code for it in ICD-9. I just found an e-mail actually from July and I guess I used 825.29. Which i agree with.... but there isn't anything in ICD-10 even close!!! UGH!


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## mhstrauss (Nov 23, 2015)

graceroni13 said:


> I'll use the unspecified if I HAVE to.... but I just haven't come across this issue before with this code so I wanted to see if anyone else has figured it out, because I guess there wasn't a code for it in ICD-9. I just found an e-mail actually from July and I guess I used 825.29. Which i agree with.... but there isn't anything in ICD-10 even close!!! UGH!



This is the kinds of issues the doctors need to push their specialty societies to request new codes for!! I agree, it is VERY frustrating!!!


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## graceroni13 (Nov 23, 2015)

I think at least ONE specialist should have been involved with these codes. I can't tell you how many times I've heard "that code doesn't exist". So much for being more specific right? haha


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## JhericaR (Nov 23, 2015)

graceroni13 said:


> in the foot, forgot to mention that haha



Sesamoids of the foot are considered part of the 1st metatarsal bone. Below are some coding options. Hope these help.

1) S92.491 - Other fracture of the Right great toe
S92.492 (Left)

2) S92.311 Displaced fracture of the 1st metatarsal, Right foot
S92.312(Left)

3) S92.901 - Unspecified fracture of the Right foot, closed
S92.902 (Left)

Remember to assign the appropriate letter based on the visit type (A-initial encouncer, D-subsequent encounter, etc.)


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## JhericaR (Nov 23, 2015)

Forgot to mention, I am a Podiatrist and these are the codes we currently use for office and hospital billing.


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## graceroni13 (Nov 23, 2015)

I just talked to the MA and she still doesn't agree. UGH! I don't know what to do :/


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## graceroni13 (Nov 23, 2015)

Well now I don't think I should question you haha. She just says that the sesamoid bones aren't a part of the toe or other bones in the foot. She says they're on their own. I just don't want to do something WRONG.


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## JhericaR (Nov 23, 2015)

The Sesamoid bones are located under the 1st metatarsal head on the plantar aspect of the hallux. They are called Fibular Sesamoid (sitting on the lateral side) and Tibial Sesamoid (which sits medially). They are held in place by ligaments which attach to the base of the proximal phalanx of the hallux. Sesamoids have to be located and considered when performing surgical procedures on the great toe of the foot.
Yes, sesamoids are considered part of the foot. 



I understand you not wanting to be wrong. I rechecked the data base to ensure I have you the proper codes. Just wanted you to have a clear picture. Hope this helps.


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## graceroni13 (Nov 24, 2015)

Thank you SO much for your help @JhericaR! I just wanted to understand and you explained it perfectly! I'll try this out and maybe, POSSIBLY, they'll come  up with a code for this in the future. I appreciate it!


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## sjackson (Mar 9, 2018)

*Sesamoid fracture*

Sesamoids can be found in many joint of the body and are usually embedded in the muscle or tendon.  The most common is probably the foot.  You should look in the Index.   By the Index under Fracture, traumatic foot S92.81 or hand see fracture carpal and finally if in any other joint then Other, fracture, traumatic, by site.


In the knee—the patella (within the quadriceps tendon). 
In the hand—two sesamoid bones are commonly found in the distal portions of the first metacarpal bone.  There is also one in distal portions of the second metacarpal bone.
In the wrist—The pisiform of the wrist is a sesamoid bone.
In the foot—the first metatarsal bone usually has two sesamoid bones at its connection to the big toe 
In the neck—its  the hyoid bone is free floating, it is not technically a sesamoid bone. 
In the ear—the lenticular process of the incus is a sesamoid bone


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