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ICD-10 Guide
ICD-10 CodesS52.279

S52.279

Billable

Monteggia's fracture of unspecified ulna

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

Code Description

ICD-10 S52.279 is a billable code used to indicate a diagnosis of monteggia's fracture of unspecified ulna.

Key Diagnostic Point:

Monteggia's fracture is characterized by an injury involving an ulna fracture accompanied by an associated fracture of the radial head. This type of fracture typically occurs due to a fall on an outstretched hand or direct trauma to the forearm. The ulna fracture may be located at various points along the bone, and the radial head fracture can lead to complications such as instability of the elbow joint. Clinically, patients may present with pain, swelling, and limited range of motion in the elbow and forearm. Diagnosis is confirmed through radiographic imaging, which reveals the fracture patterns. Treatment often involves orthopedic fixation procedures, such as internal fixation with plates and screws or external fixation, depending on the fracture's complexity and stability. Compartment syndrome is a potential complication that can arise from swelling and pressure within the forearm compartments, necessitating careful monitoring and possible fasciotomy. Accurate coding of Monteggia's fracture is essential for appropriate management and reimbursement, as it reflects the complexity of the injury and the required interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture location and type
  • Potential for associated injuries (e.g., radial head fracture)
  • Need for detailed imaging documentation
  • Variations in treatment approaches (surgical vs. non-surgical)

Audit Risk Factors

  • Inadequate documentation of fracture details
  • Failure to document associated radial head injury
  • Misclassification of fracture type
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all associated injuries are documented, including any surgical interventions performed.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans must be clearly documented.

Common Clinical Scenarios

Patients presenting with acute trauma to the forearm or elbow.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S52.279 When
  • Follow official ICD
  • CM guidelines for coding fractures, including the need to specify the type and location of the fracture
  • Ensure that documentation supports the diagnosis and any associated injuries

Exclusion Criteria

Do NOT use S52.279 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 Monteggia's fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the complexity of the fracture and any associated injuries.

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 Monteggia's fracture, which enhances the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including Monteggia's fracture, which enhances the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 Monteggia's fracture?

A Monteggia's fracture is a specific type of fracture that involves an ulna fracture along with an associated fracture of the radial head, typically resulting from trauma.