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ICD-10 Guide
ICD-10 CodesS52.091

S52.091

Billable

Other fracture of upper end of right ulna

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

Code Description

ICD-10 S52.091 is a billable code used to indicate a diagnosis of other fracture of upper end of right ulna.

Key Diagnostic Point:

The S52.091 code refers to fractures occurring at the upper end of the right ulna, which is a common injury in the context of elbow fractures. These fractures can result from various mechanisms, including falls, direct trauma, or sports injuries. The upper end of the ulna is critical for elbow stability and function, as it articulates with the humerus and radius. Fractures in this area can lead to complications such as malunion, nonunion, or post-traumatic arthritis. Symptoms typically include pain, swelling, and limited range of motion in the elbow. Diagnosis is often confirmed through imaging studies, such as X-rays or CT scans, which help assess the fracture's type and displacement. Treatment may involve conservative management with immobilization or surgical intervention, including orthopedic fixation procedures like plate and screw fixation or intramedullary nailing, depending on the fracture's complexity and stability. Compartment syndrome is a potential complication that can arise from swelling or bleeding within the forearm compartments, necessitating prompt recognition and intervention to prevent long-term functional impairment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Potential for associated soft tissue injuries
  • Need for precise documentation of fracture characteristics
  • Differentiation from similar codes for other fractures

Audit Risk Factors

  • Inadequate documentation of fracture details
  • Failure to specify laterality (right vs. left)
  • Misclassification of fracture type
  • Omission of associated conditions like compartment syndrome

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 due to falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Documentation must clearly indicate the fracture type, treatment plan, and any complications.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Acute presentations of elbow pain and swelling following trauma.

Billing Considerations

Timely documentation is crucial for accurate coding and billing.

Coding Guidelines

Inclusion Criteria

Use S52.091 When
  • According to ICD
  • 10 coding guidelines, S52
  • 091 should be used when the fracture is confirmed and documented
  • It is important to include laterality and specify if the fracture is open or closed

Exclusion Criteria

Do NOT use S52.091 When
  • Exclusion criteria include fractures that are not classified as 'other' or those that involve the distal ulna

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Open treatment of fracture of ulna

Clinical Scenario

Used when surgical intervention is required for fracture stabilization.

Documentation Requirements

Operative report detailing the procedure performed and any complications.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and the fixation method used.

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 management. S52.091 provides granularity that was not available in ICD-9.

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 management. S52.091 provides granularity that was not available in ICD-9.

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 management. S52.091 provides granularity that was not available in ICD-9.

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 are the common causes of an upper end ulna fracture?

Common causes include falls, sports injuries, and direct trauma to the elbow area.

How is an upper end ulna fracture diagnosed?

Diagnosis typically involves a physical examination followed by imaging studies such as X-rays or CT scans to assess the fracture.

What are the treatment options for this type of fracture?

Treatment may range from conservative management with immobilization to surgical intervention, depending on the fracture's complexity.