Orthopedic


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ICD-10 Orthopedic Superbill Example

Appointment Date & Time: Last Seen Date:
Patient: Gender: DOB: MR# Pat Due: INS Due:
Address: Reason:
Home Phone: Cell Phone: E-Mail:
Case Name: Case No: Case Type: Case Date:
Pr Insurance: Member ID: Co-Pay Amount: Deductible:
Rendering Provider: PCP: Referring Provider:
CPT CODES
CPT CodeDescriptionCPT CodeDescription
29826Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release28730Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
29827Arthroscopy, shoulder, surgical; with rotator cuff repair27792Open treatment of distal fibular fracture (lateral malleolus), with or without internal or external
29828Arthroscopy, shoulder, surgical; biceps tenodesis27814Open treatment of bimalleolar ankle fracture, with or without internal or external fixation
27822Open treatment of trimalleolar ankle fracture, with or without internal or external fixation, medial
and/or lateral malleolus; without fixation of posterior lip		29889Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
27486Revision of total knee arthroplasty, with or without allograft; 1 component29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
27130Hip Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft27823Open treatment of trimalleolar ankle fracture, with or without internal or external fixation, medial
and/or lateral malleolus; with fixation of posterior lip
27132Hip Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft27826Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial
plafond), with internal or external fixation; of fibula only
27134Hip Revision of total hip arthroplasty; both components, with or without autograft or allograft27827Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial
plafond), with internal or external fixation; of tibia only
27137Hip Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft27828Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial
plafond), with internal or external fixation; of both tibia and fibula
27138Hip Revision of total hip arthroplasty; femoral component only, with or without allograft27829Open treatment of distal tibiofibular joint (syndesmosis) disruption, with or without interna
27442Arthroplasty, femoral condyles or tibial plateau(s), knee25505Closed treatment of radial shaft fracture; with manipulation
27443With debridement and partial synovectomy25520Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint
27445Arthroplasty, knee, hinge prosthesis25535Closed treatment of ulnar shaft fracture; with manipulation
27446Arthroplasty, knee, condyle and plateau; medial or lateral compartment25565Closed treatment of radial and ulnar shaft fractures; with manipulation
27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)25605Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, with or
without fracture of ulnar styloid; with manipulation
27487Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component25624Closed treatment of carpal scaphoid (navicular) fracture; with manipulation
27235Percutaneous skeletal fixation of femoral fracture, proximal end, neck25690Closed treatment of lunate dislocation, with manipulation
27236Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement25680Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation
27244Intertrochanteric Femur Fracture25675Closed treatment of distal radioulnar dislocation with manipulation
27245Treatment of intertrochanteric, pertrochanteric, or subtrochanteric femoral fracture; with
intramedullary implant, with or without interlocking screws and/or cerclage		27870Ankle Arthrodesis
64721Neuroplasty and/or transposition; median nerve at carpal tunnel29887Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation
22612Posterolateral Fusion, Lumbar28715Arthrodesis, triple
22630Posterior Interbody Fusion, Lumbar28725Arthrodesis, subtalar
22800Arthrodesis, posterior, for spinal deformity, up to 6 vertebral segments28730Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
22802Arthrodesis, posterior, for spinal deformity; 7 to 12 vertebral segments28735midtarsal or tarsometatarsal treatment with flatfoot correction
22804Arthrodesis, posterior, for spinal
deformity, with or without cast;
13 or more vertebral segments		28737Revision of foot bones
63005Laminectomy without facetectomy, foraminotomy or discectomy ,lumbar, except for spondylolisthesis24538Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without
63012Laminectomy with removal of abnormal facets and/or pars interarticularis with decompression, for spondylolisthesis, lumbar24566Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation
63017Laminectomy with exploration and/or
decompression of spinal cord and/or cauda
equina, without facetectomy, foraminotomy or
discectomy, (e.g., spinal stenosis), more
than 2 vertebral segments		24582Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation
63030Laminotomy (hemilaminectomy), including partial facetectomy, foraminotomy and/or excision of herniated disc, lumbar27506Open treatment of femoral shaft fracture, with or without external fixation, with insertion of
intramedullary implant, with or without cerclage and/or locking screws
63042Laminotomy (hemilaminectomy), including partial facetectomy, foraminotomy and/or excision of herniated disc, re-exploration, lumbar27507Open treatment of femoral shaft fracture with plate/screws, with or without cerclage
63047Laminectomy, facetectomy and foraminotomy, lumbar27758Open treatment of tibial shaft fracture
27766Open treatment of medial malleolus fracture, with or without internal or external fixation27759Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or
without interlocking screws and/or cerclage
ICD CODES
ICD-10DescriptionICD-10Description
S72.499AOther fracture of lower end of unspecified femur, initial encounter for closed fractureS52.90XPUnspecified fracture of unspecified forearm, subsequent encounter for closed fracture with malunion
S82.009AUnspecified fracture of unspecified patella, initial encounter for closed fractureS52.90XQUnspecified fracture of unspecified forearm, subsequent encounter for open fracture type I or II with malunion
S82.009BUnspecified fracture of unspecified patella, initial encounter for open fracture type I or IIS52.90XRUnspecified fracture of unspecified forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S82.009CUnspecified fracture of unspecified patella, initial encounter for open fracture type IIIA, IIIB, or IIICS62.90XPUnspecified fracture of unspecified wrist and hand, subsequent encounter for fracture with malunion
S32.409AUnspecified fracture of unspecified acetabulum, initial encounter for closed fractureS72.90XPUnspecified fracture of unspecified femur, subsequent encounter for closed fracture with malunion
S32.409BUnspecified fracture of unspecified acetabulum, initial encounter for open fractureS72.90XQUnspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion
S32.501AUnspecified fracture of right pubis, initial encounter for closed fractureS72.90XRUnspecified fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S32.502AUnspecified fracture of left pubis, initial encounter for closed fractureS82.009PUnspecified fracture of unspecified patella, subsequent encounter for closed fracture with malunion
S32.509AUnspecified fracture of unspecified pubis, initial encounter for closed fractureS82.009QUnspecified fracture of unspecified patella, subsequent encounter for open fracture type I or II with malunion
S32.501BUnspecified fracture of right pubis, initial encounter for open fractureS82.009RUnspecified fracture of unspecified patella, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S32.502BUnspecified fracture of left pubis, initial encounter for open fractureS82.90XPUnspecified fracture of unspecified lower leg, subsequent encounter for closed fracture with malunion
S32.509BUnspecified fracture of unspecified pubis, initial encounter for open fractureS82.90XQUnspecified fracture of unspecified lower leg, subsequent encounter for open fracture type I or II with malunion
S32.309AUnspecified fracture of unspecified ilium, initial encounter for closed fractureS82.90XRUnspecified fracture of unspecified lower leg, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S32.609AUnspecified fracture of unspecified ischium, initial encounter for closed fractureS92.909PUnspecified fracture of unspecified foot, subsequent encounter for fracture with malunion
S32.810AMultiple fractures of pelvis with stable disruption of pelvic ring, initial encounter for closed fractureS92.919PUnspecified fracture of unspecified toe(s), subsequent encounter for fracture with malunion
S32.811AMultiple fractures of pelvis with unstable disruption of pelvic ring, initial encounter for closed fractureS02.91XKUnspecified fracture of skull, subsequent encounter for fracture with nonunion
S32.82XAMultiple fractures of pelvis without disruption of pelvic ring, initial encounter for closed fractureS02.92XKUnspecified fracture of facial bones, subsequent encounter for fracture with nonunion
S32.89XAFracture of other parts of pelvis, initial encounter for closed fractureS12.000KUnspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion
S32.309BUnspecified fracture of unspecified ilium, initial encounter for open fractureS12.001KUnspecified nondisplaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion
S32.609BUnspecified fracture of unspecified ischium, initial encounter for open fractureS12.100KUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion
S32.810BMultiple fractures of pelvis with stable disruption of pelvic ring, initial encounter for open fractureS12.101KUnspecified nondisplaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion
S32.811BMultiple fractures of pelvis with unstable disruption of pelvic ring, initial encounter for open fractureS12.200KUnspecified displaced fracture of third cervical vertebra, subsequent encounter for fracture with nonunion
S32.82XBMultiple fractures of pelvis without disruption of pelvic ring, initial encounter for open fractureS12.201KUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with nonunion
S32.89XBFracture of other parts of pelvis, initial encounter for open fractureS12.300KUnspecified displaced fracture of fourth cervical vertebra, subsequent encounter for fracture with nonunion
S82.109AUnspecified fracture of upper end of unspecified tibia, initial encounter for closed fractureS12.301KUnspecified nondisplaced fracture of fourth cervical vertebra, subsequent encounter for fracture with nonunion
S82.839AOther fracture of upper and lower end of unspecified fibula, initial encounter for closed fractureS12.400KUnspecified displaced fracture of fifth cervical vertebra, subsequent encounter for fracture with nonunion
S82.101AUnspecified fracture of upper end of right tibia, initial encounter for closed fractureS12.401KUnspecified nondisplaced fracture of fifth cervical vertebra, subsequent encounter for fracture with nonunion
S82.102AUnspecified fracture of upper end of left tibia, initial encounter for closed fractureS12.500KUnspecified displaced fracture of sixth cervical vertebra, subsequent encounter for fracture with nonunion
S82.831AOther fracture of upper and lower end of right fibula, initial encounter for closed fractureS12.501KUnspecified nondisplaced fracture of sixth cervical vertebra, subsequent encounter for fracture with nonunion
S82.832AOther fracture of upper and lower end of left fibula, initial encounter for closed fractureS12.600KUnspecified displaced fracture of seventh cervical vertebra, subsequent encounter for fracture with nonunion
S82.109BUnspecified fracture of upper end of unspecified tibia, initial encounter for open fracture type I or IIS12.601KUnspecified nondisplaced fracture of seventh cervical vertebra, subsequent encounter for fracture with nonunion
S82.109CUnspecified fracture of upper end of unspecified tibia, initial encounter for open fracture type IIIA, IIIB, or IIICS22.9XXKFracture of bony thorax, part unspecified, subsequent encounter for fracture with nonunion
S82.839BOther fracture of upper and lower end of unspecified fibula, initial encounter for open fracture type I or IIS32.9XXKFracture of unspecified parts of lumbosacral spine and pelvis, subsequent encounter for fracture with nonunion
S82.839COther fracture of upper and lower end of unspecified fibula, initial encounter for open fracture type IIIA, IIIB, or IIICS42.009KFracture of unspecified part of unspecified clavicle, subsequent encounter for fracture with nonunion
S82.101BUnspecified fracture of upper end of right tibia, initial encounter for open fracture type I or IIS42.209KUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with nonunion
S82.102BUnspecified fracture of upper end of left tibia, initial encounter for open fracture type I or IIS42.90XKFracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with nonunion
S82.831BOther fracture of upper and lower end of right fibula, initial encounter for open fracture type I or IIS52.90XKUnspecified fracture of unspecified forearm, subsequent encounter for closed fracture with nonunion
S82.832BOther fracture of upper and lower end of left fibula, initial encounter for open fracture type I or IIS52.90XMUnspecified fracture of unspecified forearm, subsequent encounter for open fracture type I or II with nonunion
S82.209AUnspecified fracture of shaft of unspecified tibia, initial encounter for closed fractureS52.90XNUnspecified fracture of unspecified forearm, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
S82.161ATorus fracture of upper end of right tibia, initial encounter for closed fractureS62.90XKUnspecified fracture of unspecified wrist and hand, subsequent encounter for fracture with nonunion
S82.162ATorus fracture of upper end of left tibia, initial encounter for closed fractureS72.90XKUnspecified fracture of unspecified femur, subsequent encounter for closed fracture with nonunion
S82.311ATorus fracture of lower end of right tibia, initial encounter for closed fractureS72.90XMUnspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
S82.312ATorus fracture of lower end of left tibia, initial encounter for closed fractureS72.90XNUnspecified fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
S82.811ATorus fracture of upper end of right fibula, initial encounter for closed fractureS82.90XKUnspecified fracture of unspecified lower leg, subsequent encounter for closed fracture with nonunion
S82.812ATorus fracture of upper end of left fibula, initial encounter for closed fractureS82.90XMUnspecified fracture of unspecified lower leg, subsequent encounter for open fracture type I or II with nonunion
S82.821ATorus fracture of lower end of right fibula, initial encounter for closed fractureS82.90XNUnspecified fracture of unspecified lower leg, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
S82.822ATorus fracture of lower end of left fibula, initial encounter for closed fractureS92.909KUnspecified fracture of unspecified foot, subsequent encounter for fracture with nonunion
S82.401AUnspecified fracture of shaft of right fibula, initial encounter for closed fractureS92.919KUnspecified fracture of unspecified toe(s), subsequent encounter for fracture with nonunion
S82.201AUnspecified fracture of shaft of right tibia, initial encounter for closed fractureM81.0Age-related osteoporosis without current pathological fracture
S82.202AUnspecified fracture of shaft of left tibia, initial encounter for closed fractureM81.8Other osteoporosis without current pathological fracture
S82.402AUnspecified fracture of shaft of left fibula, initial encounter for closed fractureM21.959Unspecified acquired deformity of unspecified thigh
S82.201BUnspecified fracture of shaft of right tibia, initial encounter for open fracture type I or IIM21.059Valgus deformity, not elsewhere classified, unspecified hip
S82.201CUnspecified fracture of shaft of right tibia, initial encounter for open fracture type IIIA, IIIB, or IIICM21.159Varus deformity, not elsewhere classified, unspecified
S12.9XXSFracture of neck, unspecified, sequelaM21.859Other specified acquired deformities of unspecified thigh
S22.009SUnspecified fracture of unspecified thoracic vertebra, sequelaM21.069Valgus deformity, not elsewhere classified, unspecified knee
S22.9XXSFracture of bony thorax, part unspecified, sequelaM21.169Varus deformity, not elsewhere classified, unspecified knee
S32.9XXSFracture of unspecified parts of lumbosacral spine and pelvis, sequelaM89.9Disorder of bone, unspecified
M84.459SPathological fracture, hip, unspecified, sequelaM94.9Disorder of cartilage, unspecified
S72.009SFracture of unspecified part of neck of unspecified femur, sequelaM94.20Chondromalacia, unspecified site
M84.369SStress fracture, unspecified tibia and fibula, sequelaM84.369AStress fracture, unspecified tibia and fibula, initial encounter for fracture
M84.376SStress fracture, unspecified foot, sequelaM89.30Hypertrophy of bone, unspecified site
M84.453SPathological fracture, unspecified femur, sequelaM89.8X9Other specified disorders of bone, unspecified site
M84.469SPathological fracture, unspecified tibia and fibula, sequelaM94.8X9Other specified disorders of cartilage, unspecified sites
S79.009SUnspecified physeal fracture of upper end of unspecified femur, sequelaM84.40XAPathological fracture, unspecified site, initial encounter for fracture
S82.009SUnspecified fracture of unspecified patella, sequelaM84.429APathological fracture, unspecified humerus, initial encounter for fracture
S82.90XSUnspecified fracture of unspecified lower leg, sequelaM84.439APathological fracture, unspecified ulna and radius, initial encounter for fracture
S92.909SUnspecified fracture of unspecified foot, sequelaM48.50XACollapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
S92.919SUnspecified fracture of unspecified toe(s), sequelaM80.08XAAge-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
S03.0XXSDislocation of jaw, sequelaM84.48XAPathological fracture, other site, initial encounter for fracture
S13.20XSDislocation of unspecified parts of neck, sequelaM84.68XAPathological fracture in other disease, other site, initial encounter for fracture
S23.20XSDislocation of unspecified part of thorax, sequelaM84.459APathological fracture, hip, unspecified, initial encounter for fracture
S33.30XSDislocation of unspecified parts of lumbar spine and pelvis, sequelaM84.453APathological fracture, unspecified femur, initial encounter for fracture
S43.306SDislocation of unspecified parts of unspecified shoulder girdle, sequelaM84.469APathological fracture, unspecified tibia and fibula, initial encounter for fracture
S63.006SUnspecified dislocation of unspecified wrist and hand, sequelaM84.419APathological fracture, unspecified shoulder, initial encounter for fracture
S73.006SUnspecified dislocation of unspecified hip, sequelaM84.479APathological fracture, unspecified toe(s), initial encounter for fracture
S83.006SUnspecified dislocation of unspecified patella, sequelaM84.48XAPathological fracture, other site, initial encounter for fracture
S83.106SUnspecified dislocation of unspecified knee, sequelaS83.429ASprain of lateral collateral ligament of unspecified knee, initial encounter
S93.06XSDislocation of unspecified ankle joint, sequelaS83.419ASprain of medial collateral ligament of unspecified knee, initial encounter
S93.306SUnspecified dislocation of unspecified foot, sequelaS83.509ASprain of unspecified cruciate ligament of unspecified knee, initial encounter
T88.9XXSComplication of surgical and medical care, unspecified, sequelaS83.60XASprain of the superior tibiofibular joint and ligament, unspecified knee, initial encounter
S42.009PFracture of unspecified part of unspecified clavicle, subsequent encounter for fracture with malunionS83.8X9ASprain of other specified parts of unspecified knee, initial encounter
S42.209PUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunionS86.819AStrain of other muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
S42.90XPFracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with malunionS83.90XASprain of unspecified site of unspecified knee, initial encounter
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