Injuries to the wrist, hand and fingers
ICD-10 Codes (0)
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Updates & Changes
FY 2026 Updates
New Codes (1)
Revised Codes (1)
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for S120-S129 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range S120-S129 pertains to injuries to the wrist, hand, and fingers. This includes fractures, dislocations, sprains, and strains, as well as injuries to muscles, tendons, ligaments, nerves, blood vessels, and soft tissues. These codes are used to document the nature, location, and severity of the injury, as well as any complications or associated conditions.
Key Usage Points:
- •Always specify the type of injury (fracture, dislocation, sprain, etc.) and the exact location (wrist, hand, finger, etc.).
- •Use additional codes to document any associated conditions or complications, such as open wounds or nerve damage.
- •Specify the laterality of the injury (right, left, bilateral).
- •Include a seventh character to indicate the episode of care (initial, subsequent, sequela).
- •Use the appropriate external cause code to document the cause of the injury.
Coding Guidelines
When to Use:
- ✓When a patient presents with a fracture of the wrist.
- ✓When a patient has a sprain or strain of a finger or thumb.
- ✓When a patient has an injury to a muscle, tendon, or ligament in the hand.
- ✓When a patient has a dislocation of a joint in the wrist or hand.
- ✓When a patient has a nerve or blood vessel injury in the wrist, hand, or fingers.
When NOT to Use:
- ✗When the injury is to the forearm or upper arm, not the wrist or hand.
- ✗When the injury is a burn or frostbite, not a mechanical injury.
- ✗When the injury is a superficial injury, such as a contusion or abrasion.
- ✗When the injury is a foreign body in the skin or subcutaneous tissue.
- ✗When the injury is a complication of a surgical procedure.
Code Exclusions
Always verify exclusions by consulting the official ICD-10-CM guidelines and the specific code descriptions.
Documentation Requirements
Documentation for injuries to the wrist, hand, and fingers should include the type of injury, the exact location, the laterality, the episode of care, any associated conditions or complications, and the external cause. It should be clear, concise, and specific, and it should be supported by clinical findings and diagnostic tests.
Clinical Information:
- •Type of injury (fracture, dislocation, sprain, etc.)
- •Exact location (wrist, hand, finger, etc.)
- •Laterality (right, left, bilateral)
- •Episode of care (initial, subsequent, sequela)
- •Associated conditions or complications (open wound, nerve damage, etc.)
Supporting Evidence:
- •Clinical findings (physical examination, imaging studies, etc.)
- •Diagnostic tests (X-ray, MRI, CT scan, etc.)
- •Treatment plan (surgery, immobilization, physical therapy, etc.)
- •External cause (fall, crush, cut, etc.)
Good Documentation Example:
Patient presents with a closed fracture of the right distal radius (wrist) due to a fall from a ladder. X-ray confirms the diagnosis. Plan is for surgical repair.
Poor Documentation Example:
Patient has a broken wrist.
Common Documentation Errors:
- ⚠Not specifying the type of injury
- ⚠Not specifying the exact location
- ⚠Not specifying the laterality
- ⚠Not including a seventh character for the episode of care
- ⚠Not documenting the external cause
Range Statistics
Coding Complexity
Coding for injuries to the wrist, hand, and fingers can be moderately complex due to the need to accurately identify the type of injury, the exact location, the laterality, the episode of care, and the external cause. It requires a thorough understanding of the anatomy of the wrist, hand, and fingers, as well as the various types of injuries and their clinical presentation. It also requires careful review of the medical documentation and close attention to detail.
Key Factors:
- ▸Determining the type of injury
- ▸Identifying the exact location
- ▸Specifying the laterality
- ▸Choosing the correct seventh character for the episode of care
- ▸Documenting the external cause
Specialty Focus
These codes are most commonly used by orthopedic surgeons, emergency medicine physicians, and primary care providers. They are also used by radiologists, physical therapists, occupational therapists, and other healthcare professionals involved in the diagnosis, treatment, and rehabilitation of these injuries.
Primary Specialties:
Clinical Scenarios:
- • A patient presents to the emergency department with a swollen and painful wrist after a fall.
- • A patient comes to the orthopedic clinic for follow-up after surgery for a fracture of the hand.
- • A patient is referred to physical therapy for rehabilitation after a sprain of a finger.
- • A patient sees his primary care provider for a check-up after a dislocation of the wrist.
- • A patient is evaluated by a radiologist for an X-ray of a suspected fracture of the thumb.
Resources & References
There are many resources available for coding injuries to the wrist, hand, and fingers. These include the official ICD-10-CM guidelines, coding manuals and handbooks, online coding tools and databases, and educational materials from professional coding organizations.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Hospital Association's Coding Clinic
- American Health Information Management Association's Code-Check
- Centers for Disease Control and Prevention's ICD-10-CM Browser Tool
Clinical References:
- American Academy of Orthopaedic Surgeons' Clinical Practice Guidelines
- American College of Emergency Physicians' Clinical Policies
- American Academy of Family Physicians' Clinical Recommendations
Educational Materials:
- American Academy of Professional Coders' ICD-10 Training
- American Health Information Management Association's ICD-10 Education
- Medical Coding Academy's ICD-10 Courses
Frequently Asked Questions
How do I code a fracture of the wrist?
First, identify the specific bone that is fractured (radius, ulna, carpal, etc.). Then, specify the laterality (right, left, bilateral). Finally, include a seventh character to indicate the episode of care (initial, subsequent, sequela).
What is the difference between a sprain and a strain?
A sprain is an injury to a ligament, while a strain is an injury to a muscle or tendon. The codes for these injuries are different, so it is important to document the correct type of injury.
How do I document the external cause of an injury?
The external cause of an injury is documented using an additional code from Chapter 20 of the ICD-10-CM. This code should specify the cause (fall, crush, cut, etc.), the place of occurrence, and the activity at the time of the injury.