2025 ICD-10-CM code S59

Other and unspecified injuries of the elbow and forearm.

Consult the official ICD-10-CM coding guidelines for further information on the appropriate use of this code and additional codes required to fully document the injury.Always code to the highest level of specificity possible based on the provider's documentation.

Modifiers may be applicable depending on the circumstances of the service provided (e.g., place of service, provider type).

Medical necessity for treatment of elbow and forearm injuries is established by the presence of symptoms such as pain, swelling, deformity, decreased range of motion, and functional limitations, supported by clinical findings on examination and diagnostic imaging. The severity of the injury, including the presence of fractures, soft tissue injuries, nerve damage, or vascular compromise, will dictate the level of medical necessity for the intervention. Treatment is deemed medically necessary when it is expected to improve the patient's condition, restore function, and reduce pain.

Diagnosis and treatment of elbow and forearm injuries fall under the responsibility of orthopedic surgeons, emergency medicine physicians, and family practitioners, depending on the setting and severity of the injury.The clinical responsibility includes obtaining a thorough patient history, conducting a physical examination, ordering and interpreting diagnostic imaging (x-rays, CT scans, MRI), determining the appropriate treatment plan, and performing any necessary surgical procedures. Post-operative care and rehabilitation are also part of the clinical responsibility.

IMPORTANT Use additional code(s) from Chapter 20 (External causes of morbidity) to specify the cause of injury.If a retained foreign body is present, use code Z18.-

In simple words: This code covers injuries to your elbow and forearm that aren't specifically described in other medical codes.These injuries can happen from accidents, overuse, or sports, and can cause pain, swelling, bruising, or broken bones.Doctors use exams and imaging tests to figure out the problem and decide on the best treatment, which might include rest, pain medicine, or surgery.

This ICD-10-CM code encompasses injuries to the elbow and forearm not specified elsewhere, including those where the provider doesn't specify the injury type or location.It includes trauma from various causes such as motor vehicle accidents, falls, sports, or overuse. The injuries may manifest as pain, bleeding, swelling, bruising, tenderness, fractures, decreased range of motion, nerve damage, infection, deformity, or vascular damage. Diagnosis involves patient history, physical examination, and imaging (X-rays, MRI, CT scans) to assess fractures and soft tissue damage.Treatment options range from wound care and splinting to surgery, depending on the severity.

Example 1: A patient falls on their outstretched arm, resulting in a fracture of the radius and ulna.The fracture is diagnosed through X-ray imaging and treated surgically with open reduction and internal fixation (ORIF)., A baseball pitcher experiences elbow pain due to overuse, diagnosed as medial epicondylitis (golfer's elbow). Treatment involves physical therapy, rest, and anti-inflammatory medications., A patient sustains a laceration to the forearm during a motor vehicle accident.The wound is cleaned and sutured in the emergency room, and the patient is given a tetanus booster.

Detailed patient history, including mechanism of injury, physical examination findings, imaging reports (X-rays, MRI, CT scans), operative reports if applicable, pathology reports if applicable, physical therapy notes, and progress notes documenting the patient's response to treatment.

** Excludes1: birth trauma (P10-P15), obstetric trauma (O70-O71); Excludes2: burns and corrosions (T20-T32), frostbite (T33-T34), injuries of wrist and hand (S60-S69), insect bite or sting, venomous (T63.4).

  • Payment Status: Active
  • Specialties:Orthopedic Surgery, Emergency Medicine, Family Medicine, Sports Medicine
  • Place of Service:Office, Emergency Room - Hospital, Inpatient Hospital, Ambulatory Surgical Center, Urgent Care Facility
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