2022 ICD-10-CM Code S82.433C
Displaced oblique fracture of shaft of unspecified fibula, initial encounter for open fracture type IIIA, IIIB, or IIIC
Code Classification
S82.433C is a billable diagnosis code used to specify a medical diagnosis of displaced oblique fracture of shaft of unspecified fibula, initial encounter for open fracture type iiia, iiib, or iiic. The code S82.433C is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
S82.433C is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like displaced oblique fracture of shaft of unspecified fibula for open fracture type iiia iiib or iiic. 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 S82.433C 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 S82.433C 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.
Coding Guidelines
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).
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code S82.433C is grouped in the following groups for version MS-DRG V39.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2021 through 09/30/2022.
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 |
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert S82.433C to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S82.433C 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.
- 823.31 - Fx fibula shaft-open (Approximate Flag)
Quality Payment Program Measures
When code S82.433C 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
Fractures
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.
[Learn More in MedlinePlus]
Leg Injuries and Disorders
Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures (broken bones).
These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg problems. For example, knee osteoarthritis, common in older people, can cause pain and limited motion. Problems in your veins in your legs can lead to varicose veins or deep vein thrombosis.
[Learn More in MedlinePlus]
Related Codes
ICD Code | Description | Valid for Submission |
---|---|---|
S82 | Fracture of lower leg, including ankle | NON-BILLABLE CODE |
S82.0 | Fracture of patella | NON-BILLABLE CODE |
S82.00 | Unspecified fracture of patella | NON-BILLABLE CODE |
S82.001 | Unspecified fracture of right patella | NON-BILLABLE CODE |
S82.001A | Unspecified fracture of right patella, initial encounter for closed fracture | BILLABLE CODE |
S82.001B | Unspecified fracture of right patella, initial encounter for open fracture type I or II | BILLABLE CODE |
S82.001C | Unspecified fracture of right patella, initial encounter for open fracture type IIIA, IIIB, or IIIC | BILLABLE CODE |
S82.001D | Unspecified fracture of right patella, subsequent encounter for closed fracture with routine healing | BILLABLE CODE |
S82.001E | Unspecified fracture of right patella, subsequent encounter for open fracture type I or II with routine healing | BILLABLE CODE |
S82.001F | Unspecified fracture of right patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing | BILLABLE CODE |
S82.001G | Unspecified fracture of right patella, subsequent encounter for closed fracture with delayed healing | BILLABLE CODE |
S82.001H | Unspecified fracture of right patella, subsequent encounter for open fracture type I or II with delayed healing | BILLABLE CODE |
S82.001J | Unspecified fracture of right patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing | BILLABLE CODE |
S82.001K | Unspecified fracture of right patella, subsequent encounter for closed fracture with nonunion | BILLABLE CODE |
S82.001M | Unspecified fracture of right patella, subsequent encounter for open fracture type I or II with nonunion | BILLABLE CODE |
S82.001N | Unspecified fracture of right patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion | BILLABLE CODE |
S82.001P | Unspecified fracture of right patella, subsequent encounter for closed fracture with malunion | BILLABLE CODE |
S82.001Q | Unspecified fracture of right patella, subsequent encounter for open fracture type I or II with malunion | BILLABLE CODE |
S82.001R | Unspecified fracture of right patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion | BILLABLE CODE |
S82.001S | Unspecified fracture of right patella, sequela | BILLABLE CODE |
S82.002 | Unspecified fracture of left patella | NON-BILLABLE CODE |
S82.002A | Unspecified fracture of left patella, initial encounter for closed fracture | BILLABLE CODE |
S82.002B | Unspecified fracture of left patella, initial encounter for open fracture type I or II | BILLABLE CODE |
S82.002C | Unspecified fracture of left patella, initial encounter for open fracture type IIIA, IIIB, or IIIC | BILLABLE CODE |
S82.002D | Unspecified fracture of left patella, subsequent encounter for closed fracture with routine healing | BILLABLE CODE |
S82.002E | Unspecified fracture of left patella, subsequent encounter for open fracture type I or II with routine healing | BILLABLE CODE |
S82.002F | Unspecified fracture of left patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing | BILLABLE CODE |
S82.002G | Unspecified fracture of left patella, subsequent encounter for closed fracture with delayed healing | BILLABLE CODE |
S82.002H | Unspecified fracture of left patella, subsequent encounter for open fracture type I or II with delayed healing | BILLABLE CODE |
S82.002J | Unspecified fracture of left patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing | BILLABLE CODE |
S82.002K | Unspecified fracture of left patella, subsequent encounter for closed fracture with nonunion | BILLABLE CODE |
S82.002M | Unspecified fracture of left patella, subsequent encounter for open fracture type I or II with nonunion | BILLABLE CODE |
S82.002N | Unspecified fracture of left patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion | BILLABLE CODE |
S82.002P | Unspecified fracture of left patella, subsequent encounter for closed fracture with malunion | BILLABLE CODE |
S82.002Q | Unspecified fracture of left patella, subsequent encounter for open fracture type I or II with malunion | BILLABLE CODE |
S82.002R | Unspecified fracture of left patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion | BILLABLE CODE |
S82.002S | Unspecified fracture of left patella, sequela | BILLABLE CODE |
S82.009 | Unspecified fracture of unspecified patella | NON-BILLABLE CODE |
S82.009A | Unspecified fracture of unspecified patella, initial encounter for closed fracture | BILLABLE CODE |
S82.009B | Unspecified fracture of unspecified patella, initial encounter for open fracture type I or II | BILLABLE CODE |
S82.009C | Unspecified fracture of unspecified patella, initial encounter for open fracture type IIIA, IIIB, or IIIC | BILLABLE CODE |
S82.009D | Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with routine healing | BILLABLE CODE |
S82.009E | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type I or II with routine healing | BILLABLE CODE |
S82.009F | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing | BILLABLE CODE |
S82.009G | Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with delayed healing | BILLABLE CODE |
S82.009H | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type I or II with delayed healing | BILLABLE CODE |
S82.009J | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing | BILLABLE CODE |
S82.009K | Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with nonunion | BILLABLE CODE |
S82.009M | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type I or II with nonunion | BILLABLE CODE |
S82.009N | Unspecified fracture of unspecified patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion | BILLABLE CODE |
S82.009P | Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with malunion | BILLABLE CODE |
Code History
- 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)