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ICD-10 Guide
ICD-10 CodesS52.11

S52.11

Billable

Torus fracture of upper end of radius

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

Code Description

ICD-10 S52.11 is a billable code used to indicate a diagnosis of torus fracture of upper end of radius.

Key Diagnostic Point:

A torus fracture, also known as a buckle fracture, is a common type of injury in children, particularly affecting the upper end of the radius near the elbow. This type of fracture occurs when one side of the bone buckles upon itself without breaking completely, often due to a fall or direct impact. The upper end of the radius is critical for forearm rotation and elbow stability. In pediatric patients, the bone is softer and more pliable, making it susceptible to this type of injury. Symptoms typically include localized pain, swelling, and tenderness around the elbow, with limited range of motion. Diagnosis is primarily through physical examination and imaging studies, such as X-rays, which reveal the characteristic buckling of the bone. Treatment usually involves immobilization with a splint or cast, and in some cases, orthopedic intervention may be necessary if the fracture is unstable or if there are associated injuries. Complications such as compartment syndrome, though rare, can occur if swelling is not managed appropriately, necessitating careful monitoring and potential surgical intervention.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Commonly encountered in pediatric populations
  • Clear diagnostic criteria based on imaging
  • Standard treatment protocols
  • Low risk of complications compared to other fracture types

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture
  • Misclassification as a complete fracture
  • Lack of follow-up documentation on healing

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Children presenting with arm pain after a fall, often with a visible deformity or swelling.

Billing Considerations

Consideration of growth plate involvement and potential for future growth disturbances.

Orthopedics

Documentation Requirements

Surgical notes if intervention is performed, including details on fixation methods.

Common Clinical Scenarios

Management of complex fractures or those requiring surgical intervention.

Billing Considerations

Documentation of any associated injuries or complications, such as compartment syndrome.

Coding Guidelines

Inclusion Criteria

Use S52.11 When
  • Follow official ICD
  • CM guidelines for coding fractures, including specificity regarding the location and type of fracture
  • Ensure to document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S52.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

25600CPT Code

Application of a cast

Clinical Scenario

Used when a torus fracture is diagnosed and requires immobilization.

Documentation Requirements

Documentation of the fracture type and location, as well as the reason for casting.

Specialty Considerations

Orthopedic specialists should ensure accurate coding for casting procedures.

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 torus fractures, which enhances the accuracy of patient records and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which enhances the accuracy of patient records and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which enhances the accuracy of patient records and treatment plans.

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 is a torus fracture?

A torus fracture is a type of incomplete fracture commonly seen in children, characterized by a bulging of the bone cortex without a complete break.