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ICD-10 Guide
ICD-10 CodesS52.209

S52.209

Billable

Unspecified fracture of shaft of unspecified ulna

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

Code Description

ICD-10 S52.209 is a billable code used to indicate a diagnosis of unspecified fracture of shaft of unspecified ulna.

Key Diagnostic Point:

An unspecified fracture of the shaft of the ulna typically occurs due to trauma, such as falls or direct blows to the forearm. The ulna, one of the two long bones in the forearm, plays a crucial role in wrist and elbow stability. Fractures in this area can lead to complications such as malunion or nonunion, affecting the patient's range of motion and functionality. In cases of severe trauma, associated injuries to the radius or elbow joint may also occur, necessitating a comprehensive evaluation. Compartment syndrome is a potential complication that can arise from fractures, particularly if there is significant swelling or bleeding within the forearm compartments. This condition requires immediate intervention to prevent permanent damage to the muscles and nerves. Orthopedic fixation procedures, such as intramedullary nailing or plating, may be indicated to stabilize the fracture and promote healing. Accurate coding of this condition is essential for proper treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the fracture type (e.g., open vs. closed)
  • Potential for associated injuries to the radius or elbow
  • Risk of complications such as compartment syndrome
  • Variability in treatment approaches (e.g., conservative vs. surgical)

Audit Risk Factors

  • Insufficient documentation of fracture details
  • Failure to document associated injuries
  • Inadequate follow-up on complications like compartment syndrome
  • Lack of clarity on treatment plans

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or vehicular accidents are frequently encountered.

Billing Considerations

Documentation must clearly indicate the mechanism of injury and any associated complications to ensure accurate coding.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment provided in the emergency setting must be documented thoroughly.

Common Clinical Scenarios

Patients presenting with acute forearm pain following trauma, often requiring immediate imaging and stabilization.

Billing Considerations

Timely documentation is critical to capture the urgency of the injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S52.209 When
  • According to ICD
  • 10 coding guidelines, fractures should be coded based on the specific site and type
  • 209 is used when the fracture is unspecified, and additional codes may be required to capture associated conditions or complications

Exclusion Criteria

Do NOT use S52.209 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

25607CPT Code

Open treatment of distal radial fracture

Clinical Scenario

Often used in conjunction with ulna fractures when both bones are involved.

Documentation Requirements

Surgical notes must detail the procedure and any fixation methods used.

Specialty Considerations

Orthopedic surgeons must ensure that both fractures are documented for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding, but the unspecified nature of S52.209 may lead to challenges in capturing the full clinical picture, impacting treatment planning and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding, but the unspecified nature of S52.209 may lead to challenges in capturing the full clinical picture, impacting treatment planning and reimbursement.

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 should I document to support the use of S52.209?

Document the mechanism of injury, imaging results, treatment plan, and any complications to ensure accurate coding and reimbursement.