# Avulsion Fracture



## elizabeth24 (Feb 26, 2014)

Do you code an avulsion fracture as an open fracture, or is it best to use 2 separate dx codes - wound, open & fracture???
To me an open fracture is obvious, but avulsion codes out as wound open.

Please help!
Thanks!!


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## tharal (Feb 27, 2014)

Hi,

When you check the alphabetic index in ICD 9 CM, 

Main term Avulsion
Sub term Fracture : see fracture by site

Avulsion is an open wound included in Fracture, which doesn't mean that the fracture is open.

see the note below:

"Closed" includes the following descriptions of fractures, with or without delayed healing, unless they are specified as open or compound:

*comminuted
depressed
elevated
fissured
greenstick
impacted
linear
simple
slipped epiphysis
spiral
unspecified*

"Open" includes the following descriptions of fractures, with or without delayed healing:
*compound
infected
missile
puncture
with foreign body*

And when you check the main term fracture in the book, you can see the "avulsion" in brackets (non-essential modifiers), which mean a simple avulsion does not affect the code assignment.

Here you can code only the fracture closed.

Hope it helps!

Thara L CPC H


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## elizabeth24 (Mar 4, 2014)

Thanks! That is what my supervisor and I finally decided upon as well.


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## daedolos (Mar 9, 2018)

So is it in the guidelines anywhere that avulsion fractures are coded as fractures or as complete ligament tears?

Peace
?_?


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