Q: ICD-9-CM includes Pott’s fracture as an alternate term for a bimalleolar fracture. However, ICD-10-CM doesn’t include that term in either the Alphabetic Index or the Tabular List. If the physician documents Pott’s fracture, can we automatically use the code for bimalleolar fractures in ICD-10-CM, even though the term is not in the index?
A: ICD-10 has eliminated most eponyms, which is why Pott’s fractures are not listed. Based on the following definition, a Pott’s fracture can be of the medial, lateral, or posterior malleolus:
During certain activities such as landing from a jump, or when rolling an ankle, stress is placed on the tibia and fibula. When this stress is traumatic, and beyond what the bone can withstand, a break in the medial, lateral, or posterior malleolus may occur. When this happens this condition is known as a Pott's fracture. Pott's fractures can vary in location, severity, and type including displaced fractures, un-displaced fractures, bimalleolar fractures, trimalleolar fractures, compound fractures, hairline, spiral, comminuted, etc.
You would need additional documentation in order to assign the correct code from S82.5-, S82.6-, S82.84-, or S82.85- in ICD-10-CM.
Editor’s Note: Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of coding and HIM for HCPro, a division of BLR in Danvers, Massachusetts, answered this question.
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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