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ICD-10 Guide
ICD-10 CodesS52.09

S52.09

Billable

Other fracture of upper end of ulna

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

Code Description

ICD-10 S52.09 is a billable code used to indicate a diagnosis of other fracture of upper end of ulna.

Key Diagnostic Point:

The upper end of the ulna is a critical area for elbow function, and fractures in this region can significantly impact mobility and strength. An 'Other fracture of upper end of ulna' refers to fractures that do not fall into the more common categories, such as simple or comminuted fractures. These fractures may occur due to direct trauma, falls, or sports injuries. Symptoms typically include localized pain, swelling, and limited range of motion in the elbow. Diagnosis is often confirmed through imaging studies such as X-rays or CT scans. Treatment may involve conservative management with immobilization or surgical intervention, particularly if there is displacement or involvement of the joint surface. Complications can include malunion, nonunion, or the development of compartment syndrome, which is a serious condition that can arise from swelling within the muscle compartments of the forearm. Proper orthopedic fixation procedures, such as the use of plates or screws, may be necessary to ensure proper alignment and healing of the fracture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and presentations
  • Need for precise documentation of fracture characteristics
  • Potential for associated injuries to the radius or elbow joint
  • Differentiation from similar codes for other types of ulnar fractures

Audit Risk Factors

  • Inadequate documentation of fracture type and location
  • Failure to document associated injuries or complications
  • Incorrect coding of fracture severity
  • Lack of clarity in operative reports for surgical procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, 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 specify the type of fracture and any surgical interventions performed.

Emergency Medicine

Documentation Requirements

Accurate initial assessment notes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute elbow pain following trauma.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S52.09 When
  • According to ICD
  • 10 coding guidelines, S52
  • 09 should be used when the fracture is specifically identified as 'other' and does not fit into more specific categories
  • Coders must ensure that documentation supports the diagnosis and any associated procedures

Exclusion Criteria

Do NOT use S52.09 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 fixation is performed for an upper end ulna fracture.

Documentation Requirements

Operative report detailing the procedure and any implants used.

Specialty Considerations

Orthopedic surgeons must provide detailed documentation of the fracture type and fixation method.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, including those of the upper end of the ulna. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including those of the upper end of the ulna. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance.

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 an upper end ulna fracture?

Common causes include falls, direct trauma, and sports injuries. Osteoporosis can also increase the risk of fractures in this area.

How is an upper end ulna fracture treated?

Treatment may involve immobilization with a splint or cast, or surgical intervention if the fracture is displaced or unstable.