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ICD-10 Guide
ICD-10 CodesS52.13

S52.13

Billable

Fracture of neck of radius

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

Code Description

ICD-10 S52.13 is a billable code used to indicate a diagnosis of fracture of neck of radius.

Key Diagnostic Point:

A fracture of the neck of the radius typically occurs just below the head of the radius, which is the uppermost part of the bone that connects to the elbow joint. This type of fracture is often associated with falls, particularly in older adults, and can result from direct trauma or twisting injuries. Clinically, patients may present with pain, swelling, and limited range of motion in the elbow and forearm. The fracture can lead to complications such as malunion or nonunion, and in some cases, it may be associated with compartment syndrome, particularly if there is significant swelling or hematoma formation. Treatment often involves immobilization, and in more severe cases, surgical intervention may be necessary to realign the bone fragments and stabilize the fracture using orthopedic fixation techniques such as plates, screws, or intramedullary nails. Rehabilitation is crucial for restoring function and preventing stiffness in the elbow joint. Accurate coding for this condition is essential for proper reimbursement and to reflect the complexity of the injury and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and associated injuries
  • Potential for complications such as compartment syndrome
  • Need for detailed documentation of treatment procedures
  • Variations in surgical approaches and fixation methods

Audit Risk Factors

  • Inadequate documentation of fracture type and location
  • Failure to document associated injuries or complications
  • Incorrect coding of surgical procedures performed
  • Lack of follow-up documentation on healing and rehabilitation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, and follow-up assessments are necessary to support the diagnosis and treatment plan.

Common Clinical Scenarios

Common scenarios include post-fall evaluations, surgical fixation of fractures, and management of complications such as compartment syndrome.

Billing Considerations

Orthopedic surgeons must ensure that all surgical interventions are clearly documented, including the type of fixation used and any complications encountered.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans must be documented thoroughly to justify the diagnosis and any immediate interventions.

Common Clinical Scenarios

Patients presenting with acute elbow pain after trauma, requiring imaging and potential referral to orthopedic surgery.

Billing Considerations

Emergency physicians should document the mechanism of injury and any neurological or vascular assessments performed.

Coding Guidelines

Inclusion Criteria

Use S52.13 When
  • According to ICD
  • 10 coding guidelines, S52
  • 13 should be used when the fracture is confirmed by imaging and documented in the medical record
  • It is important to specify whether the fracture is closed or open and to document any associated injuries

Exclusion Criteria

Do NOT use S52.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Open treatment of fracture of radius

Clinical Scenario

Used when surgical fixation is performed for a fracture of the neck of the radius.

Documentation Requirements

Operative report detailing the procedure, fixation method, and any complications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

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 neck of the radius, which enhances the ability to capture the complexity of these injuries and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including the neck of the radius, which enhances the ability to capture the complexity of these injuries and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including the neck of the radius, which enhances the ability to capture the complexity of these injuries and their management.

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 a fracture of the neck of the radius?

Common causes include falls, especially in older adults, sports injuries, and direct trauma to the elbow or forearm.

How is a fracture of the neck of the radius treated?

Treatment may involve immobilization with a splint or cast, and in some cases, surgical fixation may be necessary to ensure proper healing and restore function.