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ICD-10 Guide
ICD-10 CodesS82.126

S82.126

Billable

Nondisplaced fracture of lateral condyle of unspecified tibia

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

Code Description

ICD-10 S82.126 is a billable code used to indicate a diagnosis of nondisplaced fracture of lateral condyle of unspecified tibia.

Key Diagnostic Point:

A nondisplaced fracture of the lateral condyle of the tibia refers to a break in the bone that does not result in the bone fragments being misaligned. This type of fracture typically occurs due to trauma, such as a fall or a direct blow to the knee area. The lateral condyle is the outer part of the tibia that articulates with the femur and plays a crucial role in knee stability and function. Symptoms may include localized pain, swelling, and tenderness around the knee joint, as well as difficulty bearing weight. Diagnosis is usually confirmed through imaging studies, such as X-rays or MRI, which can help assess the extent of the injury and rule out associated ligamentous injuries. Treatment often involves conservative management, including rest, ice, compression, and elevation (RICE), along with immobilization in a brace or cast. In some cases, surgical intervention may be necessary if there are complications or if the fracture does not heal properly. Rehabilitation is essential to restore function and strength to the knee joint following the injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of fracture type and location
  • Need for precise imaging reports to confirm nondisplacement
  • Differentiation from other knee injuries such as ligament tears
  • Potential for associated injuries that complicate coding

Audit Risk Factors

  • Inadequate documentation of the fracture type
  • Failure to specify laterality or location
  • Misinterpretation of imaging results
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes if applicable, and follow-up care documentation.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of fracture type and treatment plan to avoid coding errors.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation exercises and patient response.

Common Clinical Scenarios

Post-fracture rehabilitation focusing on restoring knee function and strength.

Billing Considerations

Document specific exercises and patient progress to support therapy claims.

Coding Guidelines

Inclusion Criteria

Use S82.126 When
  • Follow ICD
  • CM guidelines for coding fractures, ensuring to document the specific site and type of fracture
  • Nondisplaced fractures should be clearly indicated in the medical record to support the use of S82

Exclusion Criteria

Do NOT use S82.126 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing knee injuries including fractures.

Documentation Requirements

Document indications for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the procedure and findings.

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 accuracy of claims and facilitating better patient care through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient care through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient care through detailed documentation.

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 a nondisplaced and displaced fracture?

A nondisplaced fracture means the bone cracks but maintains its proper alignment, while a displaced fracture involves the bone fragments being misaligned.