S92.346A Nondisplaced fracture of fourth metatarsal bone, unspecified foot, initial encounter for closed fracture

Name of the Condition

• Nondisplaced fracture of fourth metatarsal bone, unspecified foot, initial encounter for closed fracture
• ICD-10 code: S92.346A

Summary

A nondisplaced fracture of the fourth metatarsal bone is a break in the long bone of the forefoot where the bone fragments remain in their normal alignment. This code applies to the initial encounter for a closed fracture, meaning the skin is intact and no surgical intervention is required at the time of diagnosis.

Causes

Direct trauma to the foot, such as a fall or impact during physical activity, is a common cause. Stress fractures may also occur from repetitive overuse, particularly in activities involving prolonged weight-bearing or sudden increases in exercise intensity.

Risk Factors

• Participation in high-impact sports (e.g., running, basketball, soccer)
• Wearing improper or non-supportive footwear
• Conditions that weaken bones, such as osteoporosis
• Advanced age, which may reduce bone density and balance
• Previous foot injuries or fractures

Symptoms

• Pain localized to the outer midfoot area
• Swelling and bruising around the affected bone
• Difficulty bearing weight or walking on the foot
• Possible tenderness to touch

Diagnosis

A healthcare provider will perform a physical examination to assess pain, swelling, and range of motion. Imaging tests, such as X-rays, are typically used to confirm the fracture and evaluate alignment. In some cases, additional imaging like MRI may be ordered if a stress fracture is suspected but not visible on X-ray.

Treatment Options

• Rest and limited weight-bearing activities to allow healing
• Immobilization with a cast or boot to maintain proper alignment
• Pain management with NSAIDs or acetaminophen
• Gradual return to activity as healing progresses

Prognosis and Follow-Up

Most nondisplaced fractures heal well with conservative management. Follow-up care may include periodic imaging to monitor healing and adjustments to treatment plans as needed. Full recovery typically occurs within 6–8 weeks, depending on the individual's health and activity level.

Complications

• Delayed healing or nonunion if the fracture is not properly immobilized
• Chronic pain or stiffness in the foot
• Increased risk of future fractures due to weakened bone
• Rarely, infection if the fracture becomes open (not applicable to closed fractures)

Lifestyle & Prevention

• Wear supportive footwear appropriate for activity
• Gradually increase exercise intensity to avoid overuse injuries
• Maintain bone health through adequate calcium and vitamin D intake
• Use proper techniques and protective gear during sports

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, inability to bear weight, visible deformity, or signs of infection (e.g., redness, warmth, pus) around the injury site.

Tips for Medical Coders

This code is specific to a nondisplaced fracture of the fourth metatarsal bone in an unspecified foot, with the encounter classified as initial for a closed fracture. Documentation should clearly indicate the fracture type (nondisplaced), location (fourth metatarsal, unspecified foot), and encounter status (initial, closed). Ensure the record supports the absence of displacement and that no surgical intervention was performed at the time of service.