ED Coding and Reimbursement Alert

Answer: The E/M is easy enough; report 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A examination; and Medical decision making of moderate complexity...). Things get more nebulous for the diagnosis code, however.

A march fracture is the same as a stress fracture. Other terms that are considered synonymous with stress fracture are fatigue fracture, stress fracture NOS, or stress reaction. Your root ICD-10 code for this condition is M84.3- (Stress fracture). You cannot stop there, though.

Why? These diagnosis codes go to the 7th character, so you’ve got three more characters to fill out in order to complete this diagnosis.

Do this: Go back and check the notes, and try to find out:

• What part of the arm has the March fracture?
• On which side of the body is the March fracture?

Then, you can go back and choose from the following codes:

• M84.321- (Stress fracture, right humerus)
• M84.322- (Stress fracture, left humerus)
• M84.329- (Stress fracture, unspecified humerus)
• M84.331- (Stress fracture, right ulna)
• M84.332- (Stress fracture, left ulna)
• M84.333- (Stress fracture, right radius)
• M84.334- (Stress fracture, left radius)
• M84.339- (Stress fracture, unspecified ulna and radius)

Finally: You can choose the 7th character A = Initial encounter for fracture to complete your diagnosis.