Orthopedic Coding Alert

Look to these code sets for patients suffering hip dislocations.

A hip dislocation repair is a big deal; it’s a major injury that involves major recovery time (or permanent life alterations) for the patient. As a coder, you need to be right on the mark with your diagnosis coding, both to ensure your practice’s pay and the patient’s continued well-being.

The skinny: Everyone knows that choosing the correct diagnosis code is often the difference between an accepted and denied claim; when a patient has a hip dislocation, the diagnosis takes on further meaning. You’ll need to be especially accurate for the patient’s sake; if they’re misdiagnosed at any point in their treatment for this injury, it could affect how future providers care for the patient’s hip dislocation, which can recur and are sometimes chronic.

When you are coding for a hip dislocation diagnosis, the first question would be if the dislocation is if the injury is traumatic or spontaneous (chronic/recurrent), says Wayne Conway CPC, CGSC, COSC, physician coding specialist, senior, at WakeMed Physicians Practice in Raleigh, North Carolina. “This will drive what type of ICD-10 code you chose. An ‘S’ code would be chosen for a traumatic dislocation whereas an ‘M’ code would be used for a chronic or recurrent hip dislocation,” he says.

(Note: There are also other hip dislocation codes you might consider depending on encounter specifics, such as T84.021X [Dislocation of internal left hip prosthesis]. In this issue, however, we’re focusing on traumatic and spontaneous dislocations.)

There are no specific guidelines as to when a problem becomes chronic, but guidelines suggest after three or more months you should code the condition as chronic, Conway confirms. “Therefore, a traumatic dislocation is usually categorized as an anterior or posterior dislocation. A spontaneous or nontraumatic dislocation could be coded as recurrent or congenital,” he says.

According to Jennifer McNamara, CPC, CRC, CPC-I, CGSC, COPC, AAPC Approved Instructor/ Professional Recruiter at Ozark Coding Alliance LLC in Bentonville, Arkansas, ICD-10 coding for traumatic hip dislocations includes, but is not limited to, the following ICD-10 codes:

• S73.004X (Unspecified dislocation of right hip)
  S73.005X (Unspecified dislocation of left hip)
  S73.006X (Unspecified dislocation of unspecified hip)
  S73.014X (Posterior dislocation of right hip)
  S73.015X (Posterior dislocation of left hip)
  S73.016X (Posterior dislocation of unspecified hip)
• S73.024X (Obturator dislocation of right hip)
  S73.025X (Obturator dislocation of left hip)
  S73.026X (Obturator dislocation of unspecified hip)
  S73.034X (Other anterior dislocation of right hip)
  S73.035X (Other anterior dislocation of left hip)
  S73.036X (Other anterior dislocation of unspecified hip)
  S73.044X (Central dislocation of right hip)
  S73.045X (Central dislocation of left hip)
  S73.046X (Central dislocation of unspecified hip).

For spontaneous hip dislocation, ICD-10 codes you might consider include, but are not limited to, the following:

• M24.351 (Pathological dislocation of right hip, not elsewhere classified) 
  M24.352 (Pathological dislocation of left hip, not elsewhere classified) 
  M24.359 (Pathological dislocation of unspecified hip, not elsewhere classified) 
  M24.451 (Recurrent dislocation, right hip) M24.452 (Recurrent dislocation, left hip) 
  M24.459 (Recurrent dislocation, unspecified hip) 
  Q65.00 (Congenital dislocation of unspecified hip, unilateral) 
  Q65.01 (Congenital dislocation of right hip, unilateral) 
  Q65.02 (Congenital dislocation of left hip, unilateral) 
  Q65.1 (Congenital dislocation of hip, bilateral) 
  Q65.2 (Congenital dislocation of hip, unspecified) 
  Q65.30 (Congenital partial dislocation of unspecified hip, unilateral) 
  Q65.31 (Congenital partial dislocation of right hip, unilateral) 
  Q65.32 (Congenital partial dislocation of left hip, unilateral) 
  Q65.4 (Congenital partial dislocation of hip, bilateral) 
  Q65.5 (Congenital partial dislocation of hip, unspecified).

Remember: These are not complete lists of approved diagnoses for any procedure, including hip dislocation repair. The above diagnoses are merely suggested starting points to familiarize yourself with spontaneous hip dislocation diagnosis codes.