# Fracture with dislocation



## Sephardic (Mar 30, 2009)

Is it appropriate to code for a fracture and a dislocation of the same bone, or should you just assign the DX for the fracture?
Thanks in advance?


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## pharmon (Mar 31, 2009)

I always thought this was weird too, when a Dr would list fx and dislocation on the same area.  However, I was always taught to use the worst dx (fx) as the primary code.


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## ARCPC9491 (Mar 31, 2009)

I would code out the fracture dx only.


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## Lisa Bledsoe (Mar 31, 2009)

Why not both?


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## ARCPC9491 (Mar 31, 2009)

Fractures are usually associated with dislocations, so I personally would just go with the fracture. But I suppose you could do both, wouldn't hurt.


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## Lisa Bledsoe (Mar 31, 2009)

Dislocations occur at the joint; fractures occur to the bone itself.  I would code both.


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## ARCPC9491 (Mar 31, 2009)

Fracture/dislocation 
A fracture-dislocation of the same site is coded using the fracture code. It is incorrect to use an additional code for the dislocation. Likewise, reduction of the fracture-dislocation is coded using only the code for the reduction of the fracture. (See Coding Clinic, third quarter 1990, page 13.)

here's a different source:

http://www.cdphe.state.co.us/em/trauma/Registry/APPENDIXVICD9codes.pdf


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## Sephardic (Mar 31, 2009)

Thanks for the info!


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## Lisa Bledsoe (Mar 31, 2009)

AR - unfortunately I don't get Coding Clinic .  I referenced the resource link you provided and it states "same site".  If the dislocation and fracture are at differnt sites (say the dislocation is at the elbow and the fracture is on the radius *not at the joint*, how would this be coded for dx only?


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## ARCPC9491 (Mar 31, 2009)

Oh yikes now you're going to make me think 

I will try to find something in writing, but it's the trauma/force, let's say.. on the radius (fx).. that would cause the joint to dislocate. The dislocation would be the lesser of the two evils, so the fracture dx would suffice and be coded alone.. if I recall correctly.


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## Lisa Bledsoe (Apr 1, 2009)

Don't you just love how certain statements in coding can be interpreted differenty?  Makes our job that much more difficult.  However it does make us use our noggins!!


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## 007CPC (Apr 1, 2009)

ARCPC9491 said:


> Fracture/dislocation
> A fracture-dislocation of the same site is coded using the fracture code. It is incorrect to use an additional code for the dislocation. Likewise, reduction of the fracture-dislocation is coded using only the code for the reduction of the fracture. (See Coding Clinic, third quarter 1990, page 13.)
> 
> here's a different source:
> ...



I agree with ARCPC,

AHA guidelines state dislocation is inclusive with fracture episode when occuring around same location. Reduction of dislocation is inclusive with reduction of fracture. But then anything could be coded in the clinical-payer side so I guess it doesn't really matter.

JoeytheShark, CPC, CCA


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## pharmon (Apr 2, 2009)

This was great input, thank you all... and thank you for the fracture information. IT's wonderful ...  I've printed it out to use as a reference FOREVER !!!!


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## LaSeille (Apr 8, 2009)

Lisa Curtis said:


> Dislocations occur at the joint; fractures occur to the bone itself.  I would code both.



Lisa - when you look up fracture in the ICD-9 book, in parentheses next to the word fracture is dislocation.   Dislocation is included in the fracture code and therefore does not need to be listed separately (unless there are two anatomical sites being treated).  Does this help?

LaSeille Willard, CPC


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## shivap767@gmail.com (Aug 30, 2017)

*icd*



Sephardic said:


> Is it appropriate to code for a fracture and a dislocation of the same bone, or should you just assign the DX for the fracture?
> Thanks in advance?



Hi

if dislocation and fx are same site code only because dislocation included in FX icd


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