What is the ICD-10 code for malunion, proximal humerus fracture, right arm?
The correct answer and explanation is:
Correct ICD-10 Code: M84.121A
Explanation:
The ICD-10-CM code M84.121A stands for “Malunion of fracture, right humerus, initial encounter for fracture.” This code is used when a previously fractured bone in the proximal right humerus has healed improperly, resulting in a malunion.
A malunion occurs when a broken bone heals in an incorrect position. In the case of the proximal humerus, which is the upper part of the arm bone near the shoulder, malunions can affect shoulder movement, strength, and alignment. They are typically the result of inadequate initial treatment, patient noncompliance, or complications during healing.
Breakdown of the code M84.121A:
- M84 refers to disorders of bone density and structure.
- .121 specifies malunion of fracture in the right humerus.
- A is the encounter code that denotes initial encounter for the malunion (not the original fracture). Even though the fracture already occurred, the malunion itself is being addressed for the first time.
Clinical implications:
A malunion in the proximal right humerus can cause functional disability, pain, and restricted movement. It may result from the bone healing in a twisted, shortened, or otherwise deformed way. Treatment may involve physiotherapy, bracing, or surgical correction through osteotomy and realignment of the bone.
Accurate coding is important for diagnosis, billing, and treatment planning. Using the appropriate ICD-10 code ensures clear documentation and allows healthcare providers and insurance companies to understand the nature of the condition.
Note: If the encounter is for a subsequent visit related to the malunion or for a follow-up after surgery, the seventh character (e.g., D for subsequent or S for sequela) should replace the A at the end. For example, M84.121D would be used for a follow-up visit.