Valid for Submission
S52.109A is a billable diagnosis code used to specify a medical diagnosis of unspecified fracture of upper end of unspecified radius, initial encounter for closed fracture. The code S52.109A is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S52.109A might also be used to specify conditions or terms like closed fracture dislocation elbow joint, closed fracture dislocation superior radioulnar joint, closed fracture of neck of radius, closed fracture of proximal end of radius, closed fracture of proximal epiphysis of radius , closed fracture of radius and ulna, etc.
S52.109A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like unspecified fracture of upper end of unspecified radius for closed fracture. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
Unspecified diagnosis codes like S52.109A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The code S52.109A is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Communication With The Physician Or Other Clinician Managing On-going Care Post-fracture For Men And Women Aged 50 Years And Older , Osteoporosis Management In Women Who Had A Fracture.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Closed fracture dislocation elbow joint
- Closed fracture dislocation superior radioulnar joint
- Closed fracture of neck of radius
- Closed fracture of proximal end of radius
- Closed fracture of proximal epiphysis of radius
- Closed fracture of radius AND ulna
- Closed fracture of upper end of radius AND ulna
- Closed fracture subluxation of elbow joint
- Closed fracture subluxation superior radioulnar joint
- Closed multiple fractures of upper end of radius
- Closed traumatic dislocation superior radioulnar joint
- Closed traumatic subluxation of elbow
- Closed traumatic subluxation superior radioulnar joint
- Fracture dislocation of elbow joint
- Fracture of proximal end of radius
- Fracture of proximal end of radius and ulna
- Fracture of radial neck
- Fracture subluxation of elbow joint
- Open fracture of proximal end of radius
- Open fracture of radius AND ulna
- Open fracture of upper end of radius AND ulna
- Open multiple fractures of upper end of radius
Diagnostic Related Groups - MS-DRG Mapping
Convert S52.109A to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S52.109A its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Quality Payment Program Measures
When code S52.109A is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.
|Quality Measure||Description||Quality Domain||Measure Type||High Priority||Submission Methods|
|Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older||Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient's on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.||Communication and Care Coordination||Process||YES||Claims, Registry|
|Osteoporosis Management in Women Who Had a Fracture||The percentage of women age 50-85 who suffered a fracture in the six months prior to the performance period through June 30 of the performance period and who either had a bone mineral density test or received a prescription for a drug to treat osteoporosis in the six months after the fracture.||Effective Clinical Care||Process||NO||Claims, Registry|
Information for Patients
Elbow Injuries and Disorders
Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.
Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.
Other causes of elbow pain include sprains, strains, fractures, dislocations, bursitis and arthritis. Treatment depends on the cause.
- Elbow pain (Medical Encyclopedia)
- Elbow replacement (Medical Encyclopedia)
- Elbow sprain -- aftercare (Medical Encyclopedia)
- Medial epicondylitis - golfer's elbow (Medical Encyclopedia)
- Nursemaid's elbow (Medical Encyclopedia)
- Tennis elbow (Medical Encyclopedia)
- Tennis elbow surgery (Medical Encyclopedia)
[Learn More in MedlinePlus]
Also called: Broken bone
A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.
Symptoms of a fracture are
- Intense pain
- Deformity - the limb looks out of place
- Swelling, bruising, or tenderness around the injury
- Numbness and tingling
- Problems moving a limb
You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.
- Broken bone (Medical Encyclopedia)
- Closed reduction of a fractured bone (Medical Encyclopedia)
- Closed reduction of a fractured bone - aftercare (Medical Encyclopedia)
[Learn More in MedlinePlus]