ED Coding and Reimbursement Alert

Question: A patient recently arrived at the ED via ambulance with a right hip dislocation. We are having trouble determining which ICD-10 code to use. Can you advise which codes apply to traumatic and recurrent hip dislocations?

Florida Subscriber

Answer: A hip dislocation repair is a major injury that involves major recovery time (or permanent life alterations) for the patient. When you are coding for a hip dislocation diagnosis, the first question would be if the dislocation is traumatic (it happened suddenly due to a traumatic event like a fall) or chronic/recurrent. This will drive what type of ICD-10 code you chose. An “S” code would be chosen for a traumatic dislocation, whereas an “M” code applies for a chronic or recurrent hip dislocation. There are also other hip dislocation codes you might consider depending on encounter specifics, such as T84.021X (Dislocation of internal left hip prosthesis), but ED physicians typically see traumatic and spontaneous dislocations.

There are no specific guidelines as to when a problem becomes chronic, but guidelines suggest after three or more months you should code the condition as chronic. Therefore, a traumatic dislocation is usually categorized as an anterior or posterior dislocation. A spontaneous or nontraumatic dislocation could be coded as recurrent or congenital.

If you see a patient with a spontaneous posterior dislocation of his left hip, you’d report S73.015X (Posterior dislocation of left hip), but if you see a patient with a recurred dislocation of the left hip, you would instead report M24.452 (Recurrent dislocation, left hip).