Fractures

• In ICD 10 there are over 17,000 different codes for fractures
• To ensure accurate code assignment, the following details should be documented when known:
  • • Location and laterality
      i. Bone involved
      ii. Location on bone: proximal, middle, distal shaft
      iii. Right or left side if applicable
    • Open vs. closed fracture
    • Classifications
      i. Salter-Harris classification for involvement of epiphyseal plate (growth plate)
      ii. Gustilo classification for open fractures
      iii. Pelvic fracture: documentation of zone
    • Pattern
      i. Greenstick, spiral, comminuted, segmental, longitudinal or
      oblique
    • Alignment
      i. Displaced or non-displaced
    • Underlying bone disease
      i. Healthy bone
      ii. Pathologic: osteoporosis, neoplasm, etc. (often missed)
      • LINK “Fracture due to osteoporosis” when appropriate
    • Healing status
      i. Routine, delayed, nonunion
    • Etiology or cause of fracture
      i. Traumatic, pathologic, drug induced, etc.

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