What are the ICD-10 and CPT (Current Procedural Terminology) billing codes for a fracture of the left 5th finger?

ICD-10 and CPT Billing Codes for Left 5th Finger Fracture

The appropriate ICD-10 code for a fracture of the left 5th finger is S62.60xA (unspecified fracture of phalanx of left little finger, initial encounter), with more specific codes available based on the exact location and type of fracture. 1

ICD-10 Diagnostic Codes

Primary ICD-10 Codes for 5th Finger Fractures:

• S62.60xA: Unspecified fracture of phalanx of left little finger, initial encounter
• S62.61xA: Displaced fracture of proximal phalanx of left little finger, initial encounter
• S62.62xA: Displaced fracture of middle phalanx of left little finger, initial encounter
• S62.63xA: Displaced fracture of distal phalanx of left little finger, initial encounter
• S62.64xA: Nondisplaced fracture of proximal phalanx of left little finger, initial encounter
• S62.65xA: Nondisplaced fracture of middle phalanx of left little finger, initial encounter
• S62.66xA: Nondisplaced fracture of distal phalanx of left little finger, initial encounter

Additional Modifiers:

• 7th character "A" indicates initial encounter for closed fracture
• 7th character "B" indicates initial encounter for open fracture
• 7th character "D" indicates subsequent encounter with routine healing
• 7th character "G" indicates subsequent encounter with delayed healing
• 7th character "K" indicates subsequent encounter with nonunion
• 7th character "P" indicates subsequent encounter with malunion
• 7th character "S" indicates sequela

CPT Procedure Codes

Diagnostic Imaging:

• 73140: Radiologic examination, finger(s), minimum of 2 views

Non-Surgical Management:

• 29075: Application of short arm cast (below elbow to fingers)
• 29085: Application of hand/wrist cast
• 29130: Application of finger splint, static
• 29131: Application of finger splint, dynamic

Surgical Management (if required):

• 26740: Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation
• 26742: Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation
• 26746: Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, with or without internal or external fixation
• 26755: Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation
• 26756: Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb

Important Considerations

Diagnostic Requirements:

• Standard 3-view radiographic examination (PA, lateral, and oblique) is essential for proper evaluation of fifth finger fractures 1
• CT scanning is rarely necessary but may be helpful in complex cases where standard radiographs are inconclusive 1

Treatment Selection:

The choice between non-surgical and surgical management depends on:

• Fracture displacement (>5° typically requires reduction) 1
• Presence of rotation (>10° typically requires reduction or surgical intervention) 1
• Joint involvement
• Stability of the fracture after reduction

Common Pitfalls to Avoid:

1. Using incorrect 7th character for encounter type
2. Failing to update codes when transitioning from initial to subsequent care
3. Not specifying the exact location of the fracture (proximal, middle, or distal phalanx)
4. Using general hand fracture codes instead of specific finger codes
5. Not documenting medical necessity for imaging or treatment procedures

Documentation Tips:

• Clearly document the specific phalanx involved (proximal, middle, or distal)
• Note whether the fracture is displaced or nondisplaced
• Document any angulation or rotation
• Include laterality (left 5th finger)
• Document the mechanism of injury

Remember that proper coding is essential for appropriate reimbursement and accurate medical records 2. The codes should reflect the exact nature of the injury and the services provided.