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ICD-10 Guide
ICD-10 CodesS82.091

S82.091

Billable

Other fracture of right patella

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/26/2025

Code Description

ICD-10 S82.091 is a billable code used to indicate a diagnosis of other fracture of right patella.

Key Diagnostic Point:

The right patella, or kneecap, is a small bone that plays a crucial role in knee function by protecting the knee joint and enhancing the leverage of the thigh muscles. An 'other fracture' of the right patella refers to fractures that do not fall into the more common categories such as transverse, oblique, or comminuted fractures. These fractures can occur due to various mechanisms, including direct trauma, falls, or sports injuries. Symptoms typically include localized pain, swelling, and difficulty in knee movement. Diagnosis is often confirmed through imaging studies such as X-rays or MRI, which help in assessing the fracture type and any associated injuries to ligaments or cartilage. Treatment may vary from conservative management, including rest and immobilization, to surgical intervention, particularly if the fracture is displaced or involves the joint surface. Rehabilitation is essential for restoring function and strength to the knee post-injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and descriptions
  • Need for precise documentation of fracture characteristics
  • Potential for associated injuries (ligament tears, cartilage damage)
  • Differentiation from other knee injuries

Audit Risk Factors

  • Inadequate documentation of fracture type
  • Failure to document associated injuries
  • Incorrect linkage of diagnosis to treatment procedures
  • Misinterpretation of imaging results

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of fracture type, location, and any associated injuries must be documented. Imaging results should be included.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or vehicular accidents.

Billing Considerations

Ensure that all treatment plans and rehabilitation protocols are documented to support the coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Documentation of functional limitations and rehabilitation goals is essential.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture for strength and mobility.

Billing Considerations

Focus on documenting progress and any complications during rehabilitation.

Coding Guidelines

Inclusion Criteria

Use S82.091 When
  • According to ICD
  • 10 coding guidelines, S82
  • 091 should be used when the specific type of fracture is documented as 'other' and is confirmed through imaging
  • Coders must ensure that the fracture is not classified under more specific codes that describe common fracture types

Exclusion Criteria

Do NOT use S82.091 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27400CPT Code

Arthroscopy, knee, diagnostic

Clinical Scenario

Used when assessing knee injuries including fractures.

Documentation Requirements

Document the reason for the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure that the diagnosis correlates with the procedure performed.

27500CPT Code

Open treatment of patellar fracture

Clinical Scenario

Used when surgical intervention is required for a patellar fracture.

Documentation Requirements

Detailed operative notes and post-operative care plans are necessary.

Specialty Considerations

Ensure that the fracture type and treatment rationale are clearly documented.

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 the ability to capture the nuances of 'other' fractures of the patella, which aids in better tracking and management of knee injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including the ability to capture the nuances of 'other' fractures of the patella, which aids in better tracking and management of knee injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including the ability to capture the nuances of 'other' fractures of the patella, which aids in better tracking and management of knee injuries.

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 the difference between S82.091 and S82.09?

S82.091 is used for specific 'other' fractures of the right patella, while S82.09 is a more general code for unspecified fractures of the patella.

When should I use S82.091?

Use S82.091 when the documentation specifies an 'other' fracture type of the right patella that does not fit into the more common fracture classifications.