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ICD-10 Guide
ICD-10 CodesS52.009

S52.009

Billable

Unspecified fracture of upper end of unspecified ulna

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

Code Description

ICD-10 S52.009 is a billable code used to indicate a diagnosis of unspecified fracture of upper end of unspecified ulna.

Key Diagnostic Point:

An unspecified fracture of the upper end of the ulna typically occurs due to trauma, such as a fall or direct impact to the elbow region. This type of fracture can lead to significant pain, swelling, and limited range of motion in the elbow joint. The ulna is one of the two long bones in the forearm, and its upper end articulates with the humerus at the elbow joint. Fractures in this area can be associated with injuries to surrounding structures, including ligaments and tendons, and may also lead to complications such as compartment syndrome, where increased pressure within the muscle compartments can compromise blood flow and nerve function. Diagnosis is usually confirmed through imaging studies such as X-rays or CT scans, which help to visualize the fracture and assess for any displacement or associated injuries. Treatment often involves orthopedic fixation procedures, which may include casting, splinting, or surgical intervention to stabilize the fracture and restore function. Rehabilitation is crucial for recovery, focusing on restoring range of motion and strength to the affected arm.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in the fracture description
  • Potential for associated injuries that complicate coding
  • Variability in treatment approaches based on fracture severity
  • Need for precise documentation to support the diagnosis

Audit Risk Factors

  • Insufficient documentation of the fracture type
  • Inconsistent clinical notes regarding treatment
  • Failure to document associated injuries or complications
  • Lack of imaging reports to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and follow-up assessments are essential for accurate coding.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all associated injuries are documented to avoid undercoding or misrepresentation of the injury severity.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging, and treatment provided in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute elbow pain following trauma, requiring immediate evaluation and management.

Billing Considerations

Accurate documentation of mechanism of injury and initial treatment is crucial for coding and billing.

Coding Guidelines

Inclusion Criteria

Use S52.009 When
  • According to ICD
  • 10 guidelines, this code is used when the specific type of fracture is not documented
  • Coders should ensure that the documentation supports the unspecified nature of the fracture and that no more specific code is applicable

Exclusion Criteria

Do NOT use S52.009 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Closed treatment of humeral shaft fracture

Clinical Scenario

Used when a patient with an upper ulna fracture also has a humeral shaft fracture.

Documentation Requirements

Operative notes detailing the procedure and any imaging studies.

Specialty Considerations

Orthopedic surgeons should ensure that all fractures are documented to support the coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of fractures, but the unspecified nature of S52.009 can lead to challenges in accurately capturing the severity and specifics of the injury.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of fractures, but the unspecified nature of S52.009 can lead to challenges in accurately capturing the severity and specifics of the injury.

Reimbursement & Billing Impact

reimbursement.

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 does 'unspecified' mean in this code?

The term 'unspecified' indicates that the documentation does not provide enough detail to classify the fracture more specifically. Coders should ensure that they are using this code only when no other specific code applies.