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ICD-10 Guide
ICD-10 CodesP13.2

P13.2

Billable

Birth injury to femur

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 P13.2 is a billable code used to indicate a diagnosis of birth injury to femur.

Key Diagnostic Point:

Birth injury to the femur is a specific type of skeletal injury that occurs during the process of delivery. This injury can result from various factors, including the use of forceps or vacuum extraction, prolonged labor, or abnormal fetal positioning. The femur, being the longest bone in the body, is particularly susceptible to fractures during birth due to its size and the forces exerted during delivery. Clinically, a fracture of the femur may present with signs of pain, swelling, or limited mobility in the affected limb. Diagnosis is typically confirmed through physical examination and imaging studies, such as X-rays. Management of a femur fracture in a newborn may involve immobilization, pain management, and close monitoring for any complications. It is crucial for healthcare providers to document the circumstances surrounding the birth injury accurately, as this information is essential for coding and billing purposes. Understanding the nuances of birth injuries, including the femur, is vital for ensuring appropriate care and follow-up for affected infants.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of birth injuries
  • Differentiation between types of fractures and their causes
  • Need for precise coding based on clinical findings
  • Potential for co-existing conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of the delivery process
  • Failure to specify the type of fracture
  • Misclassification of the injury type
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Neonatal documentation must include detailed birth history, physical examination findings, and any imaging results. Clear notes on the mechanism of injury and treatment plan are essential.

Common Clinical Scenarios

Common scenarios include a newborn presenting with a femur fracture after a forceps-assisted delivery or a vacuum extraction. Monitoring for complications such as malunion or delayed healing is also critical.

Billing Considerations

Neonatologists should be aware of the potential for associated injuries and the need for interdisciplinary communication regarding the infant's care.

Pediatrics

Documentation Requirements

Pediatric documentation should reflect the ongoing assessment of the injury, including growth and development milestones affected by the fracture.

Common Clinical Scenarios

Pediatric scenarios may involve follow-up visits for a child with a history of a femur fracture sustained at birth, assessing mobility and developmental progress.

Billing Considerations

Pediatricians must consider the long-term implications of birth injuries on growth and development, ensuring comprehensive care.

Coding Guidelines

Inclusion Criteria

Use P13.2 When
  • According to ICD
  • 10 coding guidelines, accurate coding for birth injuries requires thorough documentation of the injury type, mechanism, and any associated conditions
  • Coders should ensure that the clinical documentation supports the diagnosis and reflects the care provided

Exclusion Criteria

Do NOT use P13.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care, per day, for evaluation and management of a normal newborn

Clinical Scenario

Used in conjunction with P13.2 for newborns with birth injuries requiring evaluation.

Documentation Requirements

Documentation must include details of the newborn's condition and any interventions performed.

Specialty Considerations

Neonatologists should ensure that all aspects of care related to the birth injury are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of birth injuries, including femur fractures, which enhances the ability to track and analyze these conditions. This specificity aids in better understanding the incidence and outcomes of birth injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of birth injuries, including femur fractures, which enhances the ability to track and analyze these conditions. This specificity aids in better understanding the incidence and outcomes of birth injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of birth injuries, including femur fractures, which enhances the ability to track and analyze these conditions. This specificity aids in better understanding the incidence and outcomes of birth injuries.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of birth injury to the femur?

Common causes include the use of forceps or vacuum extraction during delivery, prolonged labor, and abnormal fetal positioning. Understanding these factors is crucial for accurate coding and management.