# Closed treatment of acetabulum vs. ORIF



## risnerclan (Sep 16, 2009)

I am need of help.  My senerio is there is a physician on call and has a patient come into the hospital with a acetabulum fx.  the doctor tells us to charge a closed treatment of an acetbulum fx w/o manip (27220).  On the doctors notes he quotes "we tell treat patient non operatively pending results of CT scan may require surgical intervention".  We find out another dr. in the group did do an ORIF of acetbulum (27226).  when the 1st dr. was questioned on his charge he wanted to bill b/c he said at the time he was treating the patient non-op...however keep in mind what his note said.  My question is, is it appropiate to charge non-op treatment pending ct results and once ct results are in (with in 24 hours) operate and charge ORIF.  I can understand treating it non-operatively and then when you see the patient in for follow up and the fx displaces but in this situation it was not the case.  The medical decision making was not complete until the results of the CT was in.  The doctor wants something in writing showing which way would be the correct way to coding this situation.  Does anyone out there have anything that might help us in our debate.  

also, do any of your doctors try to do this as well?

Thanks,

Carol Risner


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## risnerclan (Sep 23, 2009)

Ok...everyone must be thinking da thisis common sense but after reading this, i hope you are not confused with my question...its not just for acetabulum fractures it could be for any type of a management of a fracture and then turning around and taking the patient to surgery after we have gotten ct results....please please help!

Thanks!
Carol


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