S52.569B is a billable ICD-10 code used to specify a medical diagnosis of barton's fracture of unspecified radius, initial encounter for open fracture type i or ii. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions.
S52.569B is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like barton's fracture 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 S52.569B 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 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:
- Barton's fracture
- Closed Barton's fracture
- Closed dislocation of radiocarpal joint
- Closed dorsal Barton's fracture
- Closed fracture dislocation radiocarpal joint
- Closed volar Barton's fracture
- Dorsal Barton's fracture
- Open Barton's fracture
- Open dorsal Barton's fracture
- Open fracture dislocation radiocarpal joint
- Open fracture of distal end of radius
- Open traumatic dislocation radiocarpal joint
- Open volar Barton's fracture
- Volar Barton's fracture
The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.
A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.
Initial vs. Subsequent Encounter for Fractures
Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.
Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).
Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
Convert to ICD-9 Code
|Source ICD-10 Code||Target ICD-9 Code|
|S52.569B||813.52 - Fx distal radius NEC-opn|
|Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.|
Quality Payment Program Measures
When code S52.569B 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|
Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often are swollen, very painful and visibly out of place. You may not be able to move it.
A dislocated joint is an emergency. If you have one, seek medical attention. Treatment depends on which joint you dislocate and the severity of the injury. It might include manipulations to reposition your bones, medicine, a splint or sling, and rehabilitation. When properly repositioned, a joint will usually function and move normally again in a few weeks. Once you dislocate a shoulder or kneecap, you are more likely to dislocate it again. Wearing protective gear during sports may help prevent dislocations.
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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.
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Wrist Injuries and Disorders
Your wrist connects your hand to your forearm. It is not one big joint; it has several small joints. This makes it flexible and allows you to move your hand in different ways. The wrist has two big forearm bones and eight small bones known as carpals. It also has tendons and ligaments, which are connective tissues. Tendons connect muscles to bones. Ligaments connect bones to each other.
What are the types of wrist injuries and disorders?
Some of the more common types of wrist injuries and disorders are:
- Carpal tunnel syndrome, which happens when a nerve that runs from your forearm into your palm becomes squeezed at the wrist
- Ganglion cysts, which are noncancerous lumps or masses
- Gout, which is a form of arthritis caused by a buildup of uric acid in your joints
- Fractures (broken bones)
- Osteoarthritis, the most common type of arthritis. It is caused by wear and tear of the joints.
- Sprains and strains, which are injuries to ligaments and injuries to muscles or tendons
- Tendinitis, inflammation of a tendon, usually due to overuse
Who is at risk for wrist injuries and disorders?
Certain things can put you at higher risk of having a wrist problem, including:
- Doing sports, which can put you at risk for injuries and puts stress on your wrist. For example, you may fall on your outstretched hand when you are skating or snowboarding. Your wrist could be injured while doing contact sports. And other sports such as gymnastics and basketball can strain your wrists.
- Doing repetitive wrist motions, such as typing on a keyboard, working on an assembly line, or using power tools.
- Having certain diseases. For example, rheumatoid arthritis can cause wrist pain.
What are the symptoms of wrist injuries and disorders?
The symptoms of a wrist problem can vary, depending on the problem. A common symptom is wrist pain. Some other possible symptoms include swelling, a decrease in wrist strength, and sudden numbness or tingling.
How are wrist injuries and disorders diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- A physical exam, including checking your wrist strength and range of motion
- An x-ray or other imaging test
- Blood tests
What are the treatments for wrist injuries and disorders?
Treatments for wrist pain depends on the type of injury or disorder. They may include:
- Resting your wrist
- Wearing a wrist brace or cast
- Pain relievers
- Cortisone shots
- Physical therapy
Can wrist injuries and disorders be prevented?
To try to prevent wrist problems, you can:
- Use wrist guards, when doing sports that put you at risk for wrist injuries
- In the workplace, perform stretching exercises and take frequent rest breaks. You should also pay attention to ergonomics to make sure that you are using the proper wrist position while working.
- Make sure that you get enough calcium and vitamin D to keep your bones strong
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- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)