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Nondisplaced fracture of distal phalanx of right great toe, initial encounter for closed fracture

ICD10CM code

Name of the Condition

  • Nondisplaced Fracture of Distal Phalanx of Right Great Toe (ICD-10: S92.424A)

Summary

  • This condition refers to a fracture at the tip of the bone (distal phalanx) in the right big toe. It is classified as a nondisplaced fracture, meaning the bone is cracked but remains aligned.

Causes

  • Typically caused by trauma or injury, such as stubbing the toe or dropping a heavy object on it.

Risk Factors

  • Increased risk in individuals participating in high-impact sports, those with osteoporosis, or people who engage in activities with a higher likelihood of toe injuries.

Symptoms

  • Pain and tenderness in the affected toe, swelling, bruising, and difficulty walking or bearing weight on the toe.

Diagnosis

  • Diagnosed through a physical examination and confirmed with imaging tests, such as X-rays, to determine the fracture type and alignment.

Treatment Options

  • Rest and elevation of the foot.
  • Immobilization using a stiff-soled shoe or buddy taping to neighboring toes.
  • Over-the-counter pain relievers or anti-inflammatory medications to manage pain.
  • Rarely, surgical intervention may be required if the bone does not heal properly on its own.

Prognosis and Follow-Up

  • Generally good prognosis with proper treatment, with most fractures healing within 4-6 weeks.
  • Follow-up appointments may be necessary to monitor healing and ensure proper alignment.

Complications

  • If untreated, possible complications include chronic pain, arthritis, and deformity of the toe.

Lifestyle & Prevention

  • Wear proper footwear during physical activities.
  • Use protective gear in high-risk sports.
  • Maintain a healthy diet and exercise routine to strengthen bone health.

When to Seek Professional Help

  • Severe pain or swelling, inability to move the toe, obvious deformity, or if symptoms do not improve with self-care measures.

Additional Resources

  • American Orthopaedic Foot & Ankle Society (AOFAS) - www.aofas.org
  • American Academy of Orthopaedic Surgeons (AAOS) - www.aaos.org

Tips for Medical Coders

  • Make sure to specify that the fracture is nondisplaced and involves the distal phalanx of the right great toe.
  • Ensure the coding reflects an initial encounter for a closed fracture.
  • Avoid confusion with displaced fractures or fractures of other toes or phalanges.

Medical Policies and Guidelines for Nondisplaced fracture of distal phalanx of right great toe, initial encounter for closed fracture

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