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ICD-10 Guide
ICD-10 CodesS52.20

S52.20

Billable

Unspecified fracture of shaft of ulna

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

Code Description

ICD-10 S52.20 is a billable code used to indicate a diagnosis of unspecified fracture of shaft of ulna.

Key Diagnostic Point:

An unspecified fracture of the shaft of the ulna refers to a break in the long bone of the forearm that does not have a specific classification regarding the type or location of the fracture. This injury can occur due to various mechanisms, including falls, direct blows, or twisting injuries. The ulna, along with the radius, forms the forearm and plays a crucial role in wrist and elbow function. Fractures of the ulna can lead to complications such as malunion, nonunion, or compartment syndrome, particularly if there is associated soft tissue injury. Compartment syndrome is a serious condition that arises when swelling or bleeding increases pressure within a closed muscle compartment, potentially leading to muscle and nerve damage. Treatment often involves orthopedic fixation procedures, which may include casting, splinting, or surgical intervention to stabilize the fracture and restore function. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Potential for associated injuries (e.g., radius fractures)
  • Risk of complications such as compartment syndrome
  • Need for detailed documentation to support unspecified coding

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to note associated injuries
  • Misclassification of fracture type
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the fracture type, location, and any associated injuries or complications.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or trauma requiring surgical intervention.

Billing Considerations

Ensure that all imaging studies and surgical notes are included to support the diagnosis and treatment plan.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute forearm pain and swelling after trauma.

Billing Considerations

Document the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S52.20 When
  • Follow the official ICD
  • CM coding guidelines, ensuring to document the specific nature of the fracture and any associated conditions

Exclusion Criteria

Do NOT use S52.20 When
  • Exclude codes for fractures that are more specifically defined

Related ICD-10 Codes

Related CPT Codes

25600CPT Code

Closed treatment of fracture, ulna

Clinical Scenario

Used when a closed fracture of the ulna is treated without surgical intervention.

Documentation Requirements

Document the type of fracture and treatment provided.

Specialty Considerations

Orthopedic documentation should include details of the fracture and treatment plan.

24500CPT Code

Open treatment of fracture, ulna

Clinical Scenario

Used when surgical intervention is required for an open fracture of the ulna.

Documentation Requirements

Detailed surgical notes and post-operative care documentation.

Specialty Considerations

Ensure all surgical details are captured for accurate billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to track and manage these injuries. S52.20 serves as a catch-all for unspecified fractures, but the emphasis on specificity in ICD-10 encourages better documentation practices.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to track and manage these injuries. S52.20 serves as a catch-all for unspecified fractures, but the emphasis on specificity in ICD-10 encourages better documentation practices.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to track and manage these injuries. S52.20 serves as a catch-all for unspecified fractures, but the emphasis on specificity in ICD-10 encourages better documentation practices.

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 S52.20?

Document the mechanism of injury, specific symptoms, imaging results, and any treatment provided. Ensure that any associated injuries are also noted.