Orthopedic Coding Alert

Look at type of open fracture, ignore morphology and laterality.

Don’t let elaborate ICD-10 code descriptors confuse your patellar fracture coding. As in ICD-9, you’ll retain the focus on open and closed fractures.

Submit Corresponding Code for Closed Fracture

When reporting a closed fracture of the patella, you submit ICD-9 code 822.0 (Closed fracture of patella). The corresponding ICD-10 code is S822.009A (Unspecified fracture of unspecified patella, initial encounter for closed fracture).

Confirm Type in Open Fracture

The ICD-9 code for an open fracture of patella is 822.1 (Open fracture of patella). This has two corresponding codes in ICD-10, S82.009B (Unspecified fracture of unspecified patella, initial encounter for open fracture type I or II) and S82.009C (Unspecified fracture of unspecified patella, initial encounter for open fracture type IIIA, IIIB, or IIIC). You select the appropriate code, depending upon the type of the open fracture, i.e. type I, II, or III. You report code S82.009B for open fracture type I and II, and code S82.009C for open fracture types IIIA, IIIB, and IIIC.

Ensure documentation: Make sure your surgeon documents the type of open fracture in the clinical note. Failing to do so may lead to underpayments.

Laterality and Morphology Are Not Important

Note that the descriptors of the ICD-10 codes S822.009A, S822.009B, and S822.009C are more elaborate compared to that of the ICD-9 code 822.0. The descriptors mention ‘Unspecified fracture of unspecified patella.’ This means that you do not need to look at the morphology or the laterality of the fracture.

Key: You report the same code for fracture(s) in both the right and the left patella. Laterality is not important for the ICD-10 codes for a fractured patella, either open or closed. Therefore, codes S822.009A, S82.009B, S82.009C apply to fractures in either the right or the left patella. Similarly, you won’t need to identify the fracture’s morphology — whether transverse, vertical, comminuted, or undisplaced — to accurately select your code.