Radiology Coding Alert

Reader Question:

Consider Insufficiency, Stress Fractures as Interchangeable Terms

Question: How do you code insufficiency fractures?

California Subscriber

Answer: This can be a little complicated when you are navigating through the ICD-10-CM index for the correct answer. In short, an insufficiency fracture is the same as a stress fracture. However, finding it in the ICD-10-CM can be tricky. That's because the main term of Fracture, insufficiency initially leads you to scour the index under the term Fracture, pathological. However, unless there is some underlying disease that the provider documents as causing the stress fracture, you should work under the main term of Fracture, traumatic.

As long as you know that stress fracture and insufficiency fracture are interchangeable terms, the rest is easy. Fracture, traumatic ⇒ stress leads you to M84.30 (Stress fracture, unspecified site) where you may determine the accurate code based on the site affected.