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ICD-10 Guide
ICD-10 CodesS52.12

S52.12

Billable

Fracture of head of radius

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

Code Description

ICD-10 S52.12 is a billable code used to indicate a diagnosis of fracture of head of radius.

Key Diagnostic Point:

A fracture of the head of the radius is a common injury, particularly in adults, often resulting from falls or direct trauma to the elbow. This type of fracture can lead to significant functional impairment due to its proximity to the elbow joint and the potential for associated injuries to the surrounding soft tissues, including ligaments and muscles. The head of the radius plays a crucial role in forearm rotation and elbow stability. Patients may present with pain, swelling, and limited range of motion in the elbow. Diagnosis typically involves a physical examination and imaging studies, such as X-rays, to confirm the fracture and assess for any displacement or associated injuries. Treatment options vary based on the fracture's severity and may include conservative management with immobilization or surgical intervention, such as open reduction and internal fixation (ORIF) to restore alignment and stability. Complications can include stiffness, chronic pain, and, in rare cases, compartment syndrome, which necessitates prompt recognition and intervention to prevent long-term disability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture patterns and associated injuries
  • Need for precise documentation of the fracture type and treatment
  • Potential for complications such as compartment syndrome
  • Variations in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of fracture type and treatment
  • Failure to document associated injuries or complications
  • Misclassification of fracture severity
  • Lack of follow-up documentation for surgical cases

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 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

Patients presenting with acute elbow pain following trauma.

Billing Considerations

Accurate documentation of mechanism of injury and initial management is crucial.

Coding Guidelines

Inclusion Criteria

Use S52.12 When
  • According to ICD
  • 10 guidelines, S52
  • 12 should be used when there is a confirmed fracture of the head of the radius
  • Coders must ensure that the documentation supports the diagnosis and includes details about the fracture's nature and treatment

Exclusion Criteria

Do NOT use S52.12 When
  • Exclusions include fractures not involving the head of the radius

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Open treatment of radial head fracture

Clinical Scenario

Used when surgical intervention is required for a displaced fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the surgical approach and any complications.

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 head of the radius, which enhances data accuracy and improves patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including the head of the radius, which enhances data accuracy and improves patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including the head of the radius, which enhances data accuracy and improves patient care tracking.

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 primary treatment for a fracture of the head of the radius?

Treatment may vary from conservative management with immobilization to surgical intervention, depending on the fracture's stability and displacement.