Clean Up Finger Fracture Coding With This S62.6- Documentation Primer

ICD-10 coding for finger fracture

ICD-10-CM 2019 is swapping the term “medial phalanx” to “middle phalanx” in 10 finger fracture codes. It’s a simple change, but it’s a reminder of the various factors involved in fracture coding. To help your orthopedic coding and documentation keep up with ICD-10-CM specificity, here’s a documentation checklist to help you find the right code for finger fractures fast under S62.6- (Fracture of other and unspecified finger(s)).

5th Character: Identify Phalanx and Whether Fracture Is Displaced

To choose the fifth character for your S62.6- code, you’ll need to know the phalanx (finger bone) involved. You’ll choose from proximal, middle, or distal. You’ll also need to know whether the fracture is displaced or nondisplaced.

Reminder: “A fracture not indicated as displaced or nondisplaced should be coded to displaced,” states a rule in ICD-10-CM with S62.- (Fracture at wrist and hand level).

Here are the fifth character options you have to choose from:

  • 0, unspecified
  • 1, displaced, proximal
  • 2, displaced, middle
  • 3, displaced, distal
  • 4, nondisplaced, proximal
  • 5, nondisplaced, middle
  • 6, nondisplaced, distal.

6th Character: Report Finger and Which Hand It’s On

The sixth character for the codes lets you specify which hand the fracture is on (right or left) and which finger is involved (index, middle, ring, little). Note that if the documentation doesn’t identify the hand involved, and you can’t query the provider for clarification, you should choose sixth character 8.

Here are the character options:

  • 0, right index finger
  • 1, left index finger
  • 2, right middle finger
  • 3, left middle finger
  • 4, right ring finger
  • 5, left ring finger
  • 6, right little finger
  • 7, left little finger
  • 8, other finger (including specified finger with unspecified laterality)
  • 9, unspecified finger.

Tip: Did you notice that there is no option for thumb in the characters above? You code thumb fractures under S62.5- (Fracture of thumb).

7th Character: Report the Encounter and Status

For all codes under S62.-, you must assign one of the seventh characters below.

  • A, initial encounter for closed fracture
  • B, initial encounter for open fracture
  • D, subsequent encounter for fracture with routine healing
  • G, subsequent encounter for fracture with delayed healing
  • K, subsequent encounter for fracture with nonunion
  • P, subsequent encounter for fracture with malunion
  • S, sequela.

Open/closed: “A fracture not indicated as open or closed should be coded to closed,” ICD-10-CM states.

Encounter: Choose an initial encounter code (A or B) if the patient is receiving active treatment for the fracture. A or B is also appropriate if the patient delayed seeking treatment for a fracture or nonunion, 2018 ICD-10-CM Official Guidelines for Coding and Reporting state.

Subsequent care characters D, G, K, and P are appropriate after active treatment is completed and the patient presents for routine care during healing or recovery.

Use the sequela character (S), when a patient presents for treatment of a residual effect of the fracture after the acute phase is over. You’ll typically report the sequela condition first, and then the sequela code.

Simplify With This Documentation Checklist

S62.6- (Fracture of other and unspecified finger(s))

Displaced or Nondisplaced

  • Displaced
  • Nondisplaced

Phalanx

  • Proximal
  • Middle
  • Distal

Hand

  • Right
  • Left

Finger

  • Index
  • Middle
  • Ring
  • Little

Encounter

  • Initial
    • Open
    • Closed
  • Subsequent
    • Routine healing
    • Delayed healing
    • Nonunion
    • Malunion
  • Sequela

What About You?

What strategies do you use to ensure you have the details you need to code fractures using ICD-10-CM?

 

 

 

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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