Orthopedic Coding Alert

Jones fracture is a diaphyseal fracture of the fifth metatarsal bone of the foot. This fracture may cause pain and swelling on the lateral side or middle of the foot and the patient may complain of difficulty in walking. "Jones fracture is a fracture of the base of the 5th metatarsal at the metaphyseal-diaphyseal junction.  It extends into the 4-5 intermetatarsal facet and is 1.5 cm distal to the tuberosity of the 5th metatarsal," says Ruby O’Brochta-Woodward, BSN, CPC, CCS-P, COSC, ACS-OR, compliance and research specialist, Twin Cities Orthopedics, P.A.

Such fractures are difficult to heal. "A Jones fracture is usually caused by an inversion injury to the foot, or when the foot and ankle twists inward. The fracture is often mistaken for a sprain or strain and may go undetected, which further increases the potential for non-union of the fracture," says Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR, owner, Precision Auditing and Coding, senior orthopedic coder & auditor, The Coding Network, Washington.

What to look for in the notes: The initial treatment often includes immobilization with cast and avoidance of weight bearing. Sometimes, surgery may be done for this fracture. "Jones fractures can be treated by casting or bracing or use of a stiff soled shoe, if nondisplaced. If surgical treatment is performed, IM screw, or plate fixation may be done. Non-unions are commonly treated by ORIF and grafting," says Stumpf.