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ICD-10 Guide
ICD-10 CodesS52.189

S52.189

Billable

Other fracture of upper end of unspecified radius

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

Code Description

ICD-10 S52.189 is a billable code used to indicate a diagnosis of other fracture of upper end of unspecified radius.

Key Diagnostic Point:

The S52.189 code refers to fractures at the upper end of the radius, which is the bone located on the thumb side of the forearm. These fractures can occur due to various mechanisms, including falls, direct trauma, or sports injuries. The upper end of the radius is critical for wrist and elbow function, and fractures in this area can lead to complications such as limited range of motion, pain, and instability. In particular, elbow fractures may involve the radial head, which is crucial for forearm rotation. Compartment syndrome can also arise from such injuries, especially if there is significant swelling or bleeding within the forearm compartments. Treatment often involves orthopedic fixation procedures, which may include the use of plates, screws, or intramedullary nails to stabilize the fracture and promote healing. Accurate coding 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 locations
  • Potential for associated injuries (e.g., elbow dislocation)
  • Need for detailed documentation of treatment procedures
  • Differentiation from similar codes (e.g., specific radial head fractures)

Audit Risk Factors

  • Insufficient documentation of fracture type
  • Lack of details on treatment procedures
  • Inconsistent use of codes for similar injuries
  • Failure to document complications like compartment syndrome

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up evaluations are necessary to support the diagnosis and treatment.

Common Clinical Scenarios

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

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans must be documented thoroughly.

Common Clinical Scenarios

Patients presenting with acute pain and swelling after trauma, requiring immediate evaluation and possible referral to orthopedics.

Billing Considerations

Accurate coding requires clear documentation of the mechanism of injury and initial treatment provided.

Coding Guidelines

Inclusion Criteria

Use S52.189 When
  • According to ICD
  • 10 guidelines, S52
  • 189 should be used when the fracture is not specified further
  • Coders must ensure that the documentation supports the use of this code and that it aligns with the clinical findings

Exclusion Criteria

Do NOT use S52.189 When
No specific exclusions found.

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 fracture of the upper radius.

Documentation Requirements

Operative report detailing the procedure and findings.

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 diagnoses and treatment plans. S52.189 provides a means to capture unspecified fractures, but it requires careful documentation to avoid ambiguity.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of diagnoses and treatment plans. S52.189 provides a means to capture unspecified fractures, but it requires careful documentation to avoid ambiguity.

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 is the significance of coding S52.189?

Coding S52.189 is significant as it captures unspecified fractures of the upper radius, which can have various implications for treatment and reimbursement. Accurate coding is essential for reflecting the complexity of the injury and ensuring appropriate care.