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ICD-10 Guide
ICD-10 CodesS52.00

S52.00

Billable

Unspecified fracture of upper end of ulna

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/24/2025

Code Description

ICD-10 S52.00 is a billable code used to indicate a diagnosis of unspecified fracture of upper end of ulna.

Key Diagnostic Point:

An unspecified fracture of the upper end of the ulna typically occurs in the context of trauma, often resulting from falls, direct blows, or sports injuries. This type of fracture can lead to significant pain, swelling, and limited range of motion in the elbow joint. The ulna, one of the two long bones in the forearm, plays a crucial role in the stability and function of the elbow. Fractures in this area may be associated with injuries to surrounding structures, including ligaments and tendons, and can sometimes lead to complications such as compartment syndrome, where increased pressure within the muscle compartments can impair blood flow and lead to muscle and nerve damage. Treatment often involves orthopedic fixation procedures, which may include casting or surgical intervention, depending on the fracture's severity and displacement. Accurate diagnosis and coding are essential for appropriate management and reimbursement, as well as for tracking outcomes in orthopedic care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations within the ulna
  • Potential for associated injuries to the radius or elbow joint
  • Need for detailed documentation to specify fracture characteristics
  • Differentiation from other upper extremity fractures

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to document associated injuries or complications
  • Misclassification of fracture type or location
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and follow-up assessments are essential for accurate coding.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Documentation must clearly indicate the fracture type, treatment plan, and any complications.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment provided in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute elbow pain and swelling after trauma.

Billing Considerations

Timely documentation is crucial for coding accuracy, especially in acute settings.

Coding Guidelines

Inclusion Criteria

Use S52.00 When
  • According to ICD
  • 10 coding guidelines, S52
  • 00 should be used when the specific details of the fracture are not documented
  • Coders should ensure that the documentation supports the use of this unspecified code and consider more specific codes if available

Exclusion Criteria

Do NOT use S52.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Open treatment of fracture of ulna

Clinical Scenario

Used when surgical intervention is required for an upper end ulna fracture.

Documentation Requirements

Surgical notes detailing the procedure and any complications.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and the fixation method used.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding, but the use of unspecified codes like S52.00 remains common. Coders must be diligent in ensuring that documentation supports the use of this code to avoid potential denials or audits.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding, but the use of unspecified codes like S52.00 remains common. Coders must be diligent in ensuring that documentation supports the use of this code to avoid potential denials or audits.

Reimbursement & Billing Impact

reimbursement.

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 should I document to support the use of S52.00?

Document the mechanism of injury, specific symptoms, imaging results, and any treatment provided. Ensure that the documentation clearly indicates that the fracture is unspecified and does not provide details that would warrant a more specific code.