Orthopedic Coding Alert

Here’s why dislocation status is vital.

When you are coding claims for patients who need help with traumatic or chronic/recurrent hip dislocations, ICD-10 coding is vital to securing your deserved reimbursement on each claim.

Why? There are two different diagnosis code sets, one for traumatic and one for chronic/recurrent. You’ll need to select spot-on ICD-10 codes in order for your CPT^® codes to coalesce with the diagnosis and form a proper claim.

Check out this expert advice on how to select the proper ICD-10 code for each hip dislocation repair.

First, Check Dislocation Status

“When you are coding for a hip dislocation diagnosis, the first question would be if the dislocation is traumatic or chronic/recurrent,” says Wayne Conway CPC, CGSC, COSC, physician coding specialist, senior, at WakeMed Physicians Practice in Raleigh, N.C.

“An ‘S’ code would be chosen for a traumatic dislocation, whereas an ‘M’ code would be used for a chronic or recurrent hip dislocation,” says Conway.

Unfortunately, there are no specific guidelines as to when a problem becomes chronic, but generally “after three or more months the condition should be coded as chronic. Therefore, a traumatic dislocation is usually categorized as an anterior or posterior dislocation [‘S codes]. A spontaneous or nontraumatic dislocation could be coded as recurrent or congenital [‘M’ codes],” explains Conway.

Look to These Codes

Diving deeper into the ICD-10 codes, you’ll see that Conway is referencing specific sets of codes in his explanation. You’ll find the ‘S’ codes for hip dislocation in the S73.0- (Subluxation and dislocation of hip) code set.