Pathology/Lab Coding Alert

How much more can you say about a disease-related humeral fracture (733.11, Pathological fracture of humerus)?

 

A lot, apparently, based on the fact that ICD-10 provides 85 different codes for that condition.

 

Simplify: Don’t get too overwhelmed by that number — you really just need to know five codes, but the number explodes to 85 because each of the five codes requires a sixth digit for right/left/unspecified, and each of those fifteen codes requires a seventh digit (there are six choices) to describe the encounter.  

 

Here are the five base codes you need to know:

And here are the sixth digits that you’ll apply to each of the preceding codes:

Finally, here are the seventh digit choices to describe the encounter

Heads up for pathologists: Although your work determines the final diagnosis of a pathologic fracture, much of the information needed to assign the proper ICD-10 code must come from the referring physician, such as whether the patient has age-related osteoporosis and any encounter information for the seventh digit.

 

Build a code: Here’s an example of how the base code plus sixth digit plus seventh digit go together to make one of the 85 code choices for pathologic humeral fracture: M80.022A (Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture).

 

Remember: Authorities have delayed ICD-10 implementation to Oct. 1, 2015, at the earliest. Stay tuned to these pages for further information about the official deadline, once it’s known.