Valid for Submission
S52.136B is a billable diagnosis code used to specify a medical diagnosis of nondisplaced fracture of neck of unspecified radius, initial encounter for open fracture type i or ii. The code S52.136B is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
S52.136B is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like nondisplaced fracture of neck of unspecified radius for open fracture type i or ii. 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 S52.136B 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 S52.136B 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.
Initial vs. Subsequent Encounter for Fractures
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|562||FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC||08||1.408|
|563||FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC||08||0.8708|
Convert S52.136B to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S52.136B 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 S52.136B 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 and Care Coordination||Process||YES||Claims, Registry|
|Osteoporosis Management in Women Who Had a 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 and strains, fractures (broken bones), dislocations, bursitis, and arthritis. Treatment depends on the cause.
[Learn More in MedlinePlus]
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
[Learn More in MedlinePlus]