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ICD-10 Guide
ICD-10 CodesS82.13

S82.13

Billable

Fracture of medial condyle of tibia

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/26/2025

Code Description

ICD-10 S82.13 is a billable code used to indicate a diagnosis of fracture of medial condyle of tibia.

Key Diagnostic Point:

The medial condyle of the tibia is a critical weight-bearing structure in the knee joint, and fractures in this area can significantly impact knee stability and function. A fracture of the medial condyle typically occurs due to high-energy trauma, such as falls or sports injuries, but can also result from low-energy trauma in osteoporotic patients. Clinically, patients may present with localized pain, swelling, and limited range of motion in the knee. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which can reveal the fracture's extent and any associated soft tissue injuries. Treatment often involves conservative management with immobilization and physical therapy, but surgical intervention may be necessary for displaced fractures or those involving joint surface disruption. Surgical options include open reduction and internal fixation (ORIF) or arthroscopic procedures, depending on the fracture's complexity and associated injuries. Rehabilitation is crucial for restoring function and preventing complications such as post-traumatic arthritis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of tibial fractures
  • Identifying associated ligament injuries
  • Understanding the implications of surgical versus non-surgical treatment
  • Navigating documentation requirements for orthopedic procedures

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 clarity in imaging study results

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and pre- and post-operative assessments are essential.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all surgical interventions and their indications are clearly documented to support coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations of functional status and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture or surgical repair.

Billing Considerations

Documenting the patient's response to therapy and any complications that arise during rehabilitation.

Coding Guidelines

Inclusion Criteria

Use S82.13 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture's specifics, including laterality and whether it is open or closed
  • Include any associated conditions or complications

Exclusion Criteria

Do NOT use S82.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Arthroscopy, knee, surgical; with meniscectomy

Clinical Scenario

Used when a meniscus tear is present alongside the fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure that all findings are documented to support the procedure performed.

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 data collection and reimbursement processes. S82.13 provides a clear distinction for fractures of the medial condyle, which aids in treatment planning and outcome tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S82.13 provides a clear distinction for fractures of the medial condyle, which aids in treatment planning and outcome tracking.

Reimbursement & Billing Impact

reimbursement processes. S82.13 provides a clear distinction for fractures of the medial condyle, which aids in treatment planning and outcome 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 are the common causes of a medial condyle fracture?

Common causes include high-energy trauma from sports injuries, falls, or accidents, as well as low-energy trauma in patients with osteoporosis.