Fracture of lateral orbital wall, right side
ICD-10 S02.841 is a billable code used to indicate a diagnosis of fracture of lateral orbital wall, right side.
A fracture of the lateral orbital wall, specifically on the right side, typically results from blunt trauma to the face, such as from a sports injury, motor vehicle accident, or physical assault. The lateral orbital wall is a thin bony structure that separates the orbit from the temporal fossa and the middle cranial fossa. Injuries to this area can lead to complications such as enophthalmos (sunken eye), diplopia (double vision), and potential damage to the optic nerve or surrounding structures. Diagnosis is usually confirmed through imaging studies, such as CT scans, which provide detailed views of the bony architecture of the orbit. Management may involve observation for minor fractures, while more significant fractures may require surgical intervention to repair the wall and restore orbital integrity. Complications can include persistent visual disturbances, chronic pain, and aesthetic deformities if not properly addressed.
Documentation must include the mechanism of injury, initial assessment findings, and any imaging results.
Patients presenting with facial trauma after a fall or accident, requiring immediate evaluation.
Ensure that all relevant injuries are documented, as multiple fractures may be present.
Operative reports must detail the surgical approach, findings, and any repairs made to the orbital wall.
Surgical intervention for significant fractures requiring reconstruction.
Accurate coding of surgical procedures related to the fracture is essential for reimbursement.
Used when surgical intervention is performed to repair the fracture.
Operative report detailing the procedure performed and findings.
Ensure that the surgical approach and any complications are documented.
Common causes include blunt trauma from sports injuries, falls, motor vehicle accidents, and physical altercations.
Diagnosis is typically made through clinical examination and confirmed with imaging studies, particularly CT scans.
Complications can include double vision, enophthalmos, and damage to the optic nerve, which may require surgical intervention.