Orthopedic Coder’s ICD-9 Update: New Radius, Ulna Torus Fracture Codes

Posted on 03. Jul, 2009 by Editor in Hot Coding Topics

Come Oct. 1, you’ll no longer will you look to 832.0 for nursemaid’s elbow.

Does your orthopedist treat children’s arm problems with regularity? If so, then you may have three new ICD-9 codes to use as of Oct. 1. Take advantage of this sneak peak at the proposed orthopedic additions, and you’ll be ahead of your peers.

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Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately. Orthopedic coders, however, had hoped for a wider range of codes, says Leslie A. Follebout, CPC, COSC, PCS, coding manager at Peninsula Orthopaedic Associates in Salisbury, Md.

For instance, you may not celebrate the addition of fifth digits to existing codes 274.0 (Gouty arthropathy) and 453.8 (Other venous embolism and thrombosis of other specified veins). You may, however, find some brand-new additions.

Here’s 3 New Codes to Use in Pediatric Cases

If your orthopedist treats pediatric patients for fractures, then you’re used to applying forearm fracture ICD-9 codes. These constitute nearly half of all childhood fractures. ICD-9 2010 may bring you two new torus fracture options: 813.46 (Torus fracture of ulna [alone]) and 813.47 (Torus fracture of radius and ulna).

“Torus” fractures are sometimes called “buckle” fractures, and they are stable and nondisplaced. What happens is the topmost layer of bone on one side is slightly compressed. Following the descriptors, you’ll report 813.46 when the patient fractures only the ulna.

When the patient fractures both, you’ll use 813.47.

Be careful: You shouldn’t confuse these codes with the existing torus fracture code 813.45 (Torus fracture of radius) and other radius and ulnar fracture codes specified in the 813.xx (Fracture of radius and ulna) range.

Secondly, you’ll need to know 832.2 (Nursemaid’s elbow). Most likely, you will use 832.2 for pediatric patients between 1 to 3 years of age.

This condition is a subtle subluxation of the elbow joint – specifically the radio-capitellar joint. By suddenly pulling on an uncooperative child’s arm, adults can cause this condition. Your orthopedist may also use the term “radial head subluxation.”

Currently: As for now, ICD-9 directs you to 832.0x (Dislocation of elbow; closed dislocation) for this condition, Follebout says.

To read the complete list of proposed new, revised, and deleted ICD-9 codes that may take effect on Oct. 1, go here and scroll to page 409. The ICD-9 codes also appear in the May 22 Federal Register.

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Tags: 274.0, 453.8, 813.46, 813.47, 813.5, 832.0x, 832.2, diagnosis code, fracture, ICD-9 2010, nursemaid's elbow, orthopedic, radius, torus, ulna