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Wiki Coding a Fracture

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Lulu20

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This is regarding outpatient services- Can a MD code for a fracture without doing an X-ray first? I am not finding anything online saying that a fracture has to be proven by x-ray before it can be coded. And help on this would be greatly appreciated
 
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Yes, the provider can code for a fracture in this instance. Per the ICD-10-CM Official Guidelines, Section I.A.19, "The assignment of a diagnosis code is based on the provider's diagnostic statement that the condition exists. The provider's statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis."

Hope this helps!
 
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