S82.462C is a billable diagnosis code used to specify a medical diagnosis of displaced segmental fracture of shaft of left fibula, initial encounter for open fracture type iiia, iiib, or iiic. The code S82.462C is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
S82.462C 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 segmental fracture of shaft of left 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.
The code S82.462C 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 S82.462C to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S82.462C 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 S82.462C 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
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]
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]
|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|
|S82.001G||Unspecified fracture of right patella, subsequent encounter for closed fracture with delayed healing||BILLABLE CODE|
|S82.001K||Unspecified fracture of right patella, subsequent encounter for closed fracture with nonunion||BILLABLE CODE|
|S82.001P||Unspecified fracture of right patella, subsequent encounter for closed fracture 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|
|S82.002G||Unspecified fracture of left patella, subsequent encounter for closed fracture with delayed healing||BILLABLE CODE|
|S82.002K||Unspecified fracture of left patella, subsequent encounter for closed fracture with nonunion||BILLABLE CODE|
|S82.002P||Unspecified fracture of left patella, subsequent encounter for closed fracture 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|
|S82.009K||Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with nonunion||BILLABLE CODE|
|S82.009P||Unspecified fracture of unspecified patella, subsequent encounter for closed fracture with malunion||BILLABLE CODE|