Plain radiographs of the left ankle, foot and lower leg were then obtained, which failed to demonstrate evidence of left fibular fracture. Longitudinal views of the left distal fibula demonstrated an obvious cortical defect of the left lateral malleolus consistent with fracture ( Image 1). The remainder of the physical exam was unremarkable. Sensation was intact over the foot and ankle, and the pedal pulses were intact. Passive range of motion was limited due to pain, and the patient could not bear weight on the left foot. There was mild tenderness over the medial malleolus, and no tenderness to the base of the fifth metatarsal. There was tenderness to palpation over the distal aspect of the left lateral malleolus and the calcaneofibular and anterior talofibular ligaments.
ICD 10 CODE FOR WEBER B DISTAL FIBULA FRACTURE SKIN
Examination of the left ankle revealed intact skin and moderate soft tissue swelling. On physical examination, she was in mild distress with stable vital signs. She reported no history of surgery or trauma to the ankle prior to the presenting injury. The patient presented approximately one hour after the injury. This report describes the value of point-of-care ultrasound (POCUS) as a supplemental imaging modality in the evaluation of ankle injuries to aid in making the diagnosis of ankle fracture.Ī 45-year-old previously healthy woman presented to the ED with a chief complaint of left ankle pain after a fall while roller skating, which resulted in an inversion injury to the left ankle. Furthermore, radiographic imaging necessitates radiation exposure and additional cost. Additionally, plain film radiography is not completely sensitive for ankle fracture, resulting in false negatives. This results in many false positives with increased radiation exposure and additional costs. The OARs are designed to decrease radiographic evaluation of ankle injuries they have a high sensitivity but very low specificity for fracture diagnosis. The current standard of care for the evaluation and diagnosis of ankle fracture, when indicated by the Ottawa Ankle Rules (OARs), is plain film radiography. 1 It is important to accurately differentiate ankle fractures and other serious injuries requiring orthopedic consultation from less serious injuries that may be managed conservatively. T67.4XXA Initial Encounter or T67.4XXD Subsequent Encounter.Ankle injuries are a common presenting complaint in the emergency department (ED), comprising approximately 5% of all ED visits. The ICD-10-CM code T67.4 (Heat exhaustion due to salt depletion) requires an Episode of Care identifier. The 7th character must always be the 7th position of a code. What is 7th Character Extension? For codes less than 6 characters that require a 7th character a placeholder 'X' should be assigned for all characters less than 6. Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion Subsequent encounter for open fracture type I or II with malunion Subsequent encounter for closed fracture with malunion Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion Subsequent encounter for open fracture type I or II with nonunion Subsequent encounter for closed fracture with nonunion Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing Subsequent encounter for open fracture type I or II with delayed healing Subsequent encounter for closed fracture with delayed healing
Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing Subsequent encounter for open fracture type I or II with routine healing Initial encounter for open fracture type IIIA, IIIB, or IIIC Initial encounter for open fracture type I or II
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