Wiki TYPO in Optum?

[daedolos]

Page 930 shows S42.391 and S42.392 with the Unspecified Dx symbol. But the description doesn't mention unspecified and similar listings on other fractures elsewhere show them to be ok to be processed by claims. Please advise.

Peace
@_*

 

[greatbiller]

A seventh character is required to provide additional information regarding the fracture.

 

[AlanPechacek]

S42.391 _ and S42.392 _ are the codes for "Other" fractures of the Humeral shaft, i.e. "None of the above" fracture patterns included in S42.31, S42.32, S42.33, S42.34, S42.35, or S42.36.

Respectfully, Alan Pechacek, M.D.
icd10orthocoder.com

 

[daedolos]

The Optum 2017 ICD-10 CM designates above codes as unspecified with the marker symbol on the far right. I've been told that that symbol basically means not payable on claim.

Peace
@_*

 

[dkeown]

The Optum 2017 ICD-10 CM designates above codes as unspecified with the marker symbol on the far right. I've been told that that symbol basically means not payable on claim.

Peace
@_*

If you submit either of those codes as shown, they would be unspecified; that it why the Pink chart at the beginning of the S42 codes state:

The appropriate 7th character is to be added to all codes from category S42 [unless otherwise indicated].

Always check the beginning of your code selection for such information to help you choose the correct code.

David E. Keown, CPC, OCS