Orthopedic Coding Alert

Reader Questions:

'Joint Fracture' Is a Misnomer

Question: Which diagnosis code should I use for an SI joint fracture?Ohio SubscriberAnswer: When looking at these types of fractures, you should keep in mind that you can't have a sacroiliac (SI) joint fracture because you can't fracture a joint, only a bone. Consequently, this would be either a sacral fracture at the SI joint (806.6x, Fracture of vertebral column with spinal cord injury; sacrum and coccyx, closed; or 805.6, Fracture of vertebral column without mention of spinal cord injury; sacrum and coccyx, closed) or a fracture of the ilium (808.41, Fracture of pelvis; other specified part, closed; ilium).Before you report this, however, you should check to make sure that this is a true fracture and not a stress fracture because this distinction can change your diagnosis coding. If this is a stress fracture, you'll report 733.95 (Stress fracture of other bone) as well as the sacral or ilium fracture [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Orthopedic Coding Alert

View All