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ICD-10 Guide
ICD-10 CodesS82.16

S82.16

Billable

Torus fracture of upper end of tibia

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

Code Description

ICD-10 S82.16 is a billable code used to indicate a diagnosis of torus fracture of upper end of tibia.

Key Diagnostic Point:

A torus fracture, also known as a buckle fracture, is a common type of incomplete fracture typically seen in children due to the pliability of their bones. In the case of a torus fracture of the upper end of the tibia, the fracture occurs at the proximal tibia, which is the area just below the knee joint. This type of fracture is characterized by a bulging or buckling of the bone cortex without a complete break, making it less severe than a complete fracture. The mechanism of injury often involves a fall or direct impact to the knee area, leading to localized pain, swelling, and tenderness. Diagnosis is usually confirmed through radiographic imaging, which reveals the characteristic deformity of the bone. Treatment typically involves immobilization with a cast or splint, and in most cases, the prognosis is excellent, with full recovery expected. However, careful monitoring is necessary to ensure proper healing and to prevent complications such as malunion or growth disturbances in pediatric patients. Understanding the nuances of this fracture type is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Commonly seen in pediatric patients, making it easier to identify.
  • Clear diagnostic criteria based on imaging.
  • Standard treatment protocols are well established.
  • Minimal variations in documentation requirements.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to specify the type of fracture (e.g., torus vs. complete).
  • Misclassification of the fracture location.
  • Lack of follow-up documentation to confirm healing.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Children presenting with knee pain after a fall, often with swelling and tenderness.

Billing Considerations

Consideration of growth plate involvement and potential for future complications.

Orthopedic Surgery

Documentation Requirements

Surgical notes if intervention is required, imaging studies, and follow-up care documentation.

Common Clinical Scenarios

Cases where conservative management fails and surgical intervention is considered.

Billing Considerations

Documentation of any surgical procedures performed and post-operative care.

Coding Guidelines

Inclusion Criteria

Use S82.16 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type and location
  • Include any relevant modifiers if applicable

Exclusion Criteria

Do NOT use S82.16 When
  • Exclude coding for complete fractures or other types of injuries unless specified

Related ICD-10 Codes

Related CPT Codes

28485CPT Code

Closed treatment of tibial fracture

Clinical Scenario

Used when a torus fracture requires manipulation or casting.

Documentation Requirements

Document the type of fracture and treatment provided.

Specialty Considerations

Orthopedic specialists should ensure detailed operative notes are available.

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 torus fractures, which helps in better tracking and management of pediatric injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which helps in better tracking and management of pediatric injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which helps in better tracking and management of pediatric injuries.

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 a torus fracture?

A torus fracture is an incomplete fracture that occurs when one side of the bone buckles without breaking the other side, commonly seen in children.