Radiology Coding Alert

Question: Our physician documented a fracture to the intertrochanteric femur region. Should we report a hip fracture ICD-9 code or a femur fracture ICD-9 code?


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Answer: If your physician specifically notes a fracture to the intertrochanteric region, you should report the appropriate code from ICD-9's femoral neck section.

If the patient has a closed fracture, report 820.21 (Fracture of neck of femur; pertrochanteric fracture, closed; intertrochanteric section).

If the patient has an open fracture, however, choose 820.31 (... pertrochanteric fracture, open; intertrochanteric section).

Before you assign an ICD-9 code, the physician must indicate which bony component of the hip your patient fractured (for example, the femoral head, femoral neck, acetabulum, etc).

General rule: A hip fracture typically refers to a fracture of the neck or intertrochanteric portion of the proximal femur.

To code a true femur fracture, look for a femur fracture below the level of the lesser trochanter in the mid-shaft area.