Know Anatomy to Save Time with Fracture Coding

Understanding bone anatomy will make your fracture coding more accurate and efficient. 

For example: Suppose your patient has fractured his pisiform. If you search for “pisiform” under “fracture, traumatic” in the alphabetic index, you’ll find a note telling you to “see fracture, carpal, pisiform,” forcing you to essentially start your search over.

To save time in your search for a fractured wrist code in the alphabetic index, look up the subterm “carpal bone” underneath “fracture, traumatic.” Then search for the specific bone, such as pisiform, which will take you directly to the correct code S62.16- (Fracture of pisiform).

There’s no single code for a generic “wrist fracture” in ICD-10. Instead, there are well over 100 unique wrist fracture codes. These codes are broken down by which wrist bone is fractured, what part of the bone is affected, whether it’s the patient’s right or left wrist, and whether the fracture is displaced or non-displaced. 

For example: S62.014D corresponds to Nondisplaced fracture of distal pole of navicular [scaphoid] bone of right wrist, subsequent encounter for fracture with routine healing.
 
So, if you know that the pisiform and scaphoid are two of the eight separate “carpal bones” that make up the wrist, you’ll be able to move quickly through the index and pinpoint the specific section of the tabular list where you can find the correct code.
 
Tip: You’ll find codes for fractured scaphoid bones in a separate subcategory (S62.0-, Fracture of navicular [scaphoid] bone of wrist) from the remaining seven carpal bones, which are found in S62.1- (Fracture of other and unspecified carpal bone(s)). The S62.0- subcategory codes allow for greater detail, capturing fractures of the distal pole, middle third and proximal third of the scaphoid bone, according to the tabular list.