Wiki Radial collateral ligament thumb

As usual, ICD-10 has made a confusing mess of "Sprains" of the Joints of the Fingers &/or Thumb (S63.6 Code Set) and the "Traumatic Rupture of Ligaments" of the "Finger(s)" at the MP and IP Joints (Code Set of S63.4). A "Sprain" is a Ligamentous Injury, anywhere from mild to moderate to severe (complete tear/rupture of a ligament). ICD-10 does not really differentiate between mild, moderate, or severe "Sprains" or "Traumatic Ruptures" of the Ligaments, which from an Orthopedic perspective are essentially one in the same. Of course, Subluxations and Dislocations (S63.1 and S63.2 Code Sets) are the most severe/extreme forms of joint ligamentous injuries. The S63.6 Code Set Excludes the S63.4 Code Set, and the S63.4 Code Set also Excludes the Thumb. Why these are all separated this way is totally bizarre and incomprehensible to me.
As for the Thumb, the most common ligamentous injury/sprain is to the Ulnar Collateral Ligament of the MP joint, resulting in what is often called Game Keeper's or Skier's Thumb. The Radial Collateral Ligament could be injured at the MP Joint level, but is quite uncommon when compared to the Ulnar Collateral Ligament. The S63.64 _ _ code covers both the Ulnar and Radial Collateral Ligament injuries. "Sprains" of the Radial and Ulnar Collateral Ligaments of the IP Joint are infrequent when compared to the MP Joint injuries, but can occur. The S63.62 _ _ code would again cover both the Radial and Ulnar Collateral Ligament injuries.
So, the crucial information is which joint level has been injured? The physician needs to specify this in his documentation.

I hope this helps some.

Respectfully submitted, Alan Pechacek, M.D.