Part B Insider (Multispecialty) Coding Alert

Reader Questions:

'Joint Fracture' Is a Misnomer

Question:

Which diagnosis code should I use for an SI joint fracture?

Answer:

When looking at these types of fractures, you should keep in mind that you can't have a sacroiliac (SI) joint fracture because you can't fracture a joint, only a bone. Consequently, this would be either a sacral fracture at the SI joint (806.6x, Fracture of vertebral column with spinal cord injury; sacrum and coccyx, closed; or 805.6, Fracture of vertebral column without mention of spinal cord injury; sacrum and coccyx, closed) or a fracture of the ilium (808.41, Fracture of pelvis; other specified part, closed; ilium).

Before you report this, however, you should check to make sure that this is a true fracture and not a stress fracture because this distinction can change your diagnosis coding. If this is a stress fracture, you'll report 733.95 (Stress fracture of other bone) as well as the sacral or ilium fracture code.

Other Articles in this issue of

Part B Insider (Multispecialty) Coding Alert

View All