Radiology Coding Alert

Question: A 22-year-old patient presented to the emergency department (ED) with an injury sustained in a football game. The patient suffered a lower extremity injury when they were tackled. They complained of severe left foot pain and had trouble putting weight on their foot. The physician ordered X-rays, and then ordered computed tomography (CT) and magnetic resonance imaging (MRI) scans to further evaluate the structure. After reviewing the images, the physician diagnosed the patient with a Lisfranc injury of the left foot.

How do I report the diagnosis?

New York Subscriber

Answer: You’ll assign S93.322A (Subluxation of tarsometatarsal joint of left foot, initial encounter) to report the Lisfranc injury of the patient’s left foot. A Lisfranc injury is a type of injury affecting the bones, ligaments, or both parts in the middle of the foot. When the foot is twisted during a fall, the bones in this part of the foot can fracture or become dislocated. The tarsometatarsal joint is the body structure that is damaged in a Lisfranc injury, which is named after a French surgeon, Jacques Lisfranc de St. Martin. The injury is rare but is common in football and soccer players.

To locate the diagnosis code, you’ll open the ICD-10-CM Alphabetic Index and look for Dislocation > foot > tarsometatarsal joint, which directs you to S93.32- (Subluxation and dislocation of tarsometatarsal joint). When you verify the code in the Tabular List, you’ll find that 6th and 7th characters are needed to complete the code. The 6th character specifies laterality, which is 2 for the left foot in this case. The 7th character, A, indicates the type of encounter, which in this case is the first encounter for the injury.