# ICD 9 for fracture of femur



## Lekishak (Sep 21, 2008)

Pt. comes into hospital from nursing home 1 week after a fall for an open reduction and internal fixation of her trochanteric fracture of the femur. Which ICD 9 code should I use? I chose the 820.30 and was incorrect. The other codes given were 820.20, 821.39, 821.00. They want the most specific code for the higher reimbursement. Please help. It's concerning HCC coding.


----------



## pharmon (Sep 21, 2008)

Was the fx open at the time she arrived?  Thats an open fx code you are using.  The open reduction is where they are opening the fx to fix it.  So you have a closed fx and thats probably why they are rejecting.  Try 820.21 for closed.


----------



## KellyCPCCPCO (Sep 21, 2008)

I agree with the above poster. You cannot assume that originally it was an open fracture.


----------



## amolson1325 (Sep 21, 2008)

I'm glad I'm on the right track...this is what I posted on the other (student forum) thread earlier~

_I don't have much experience with reimbursement yet...so someone else probably should jump in. But from the scenario you are giving with those codes it dawned on me that it doesn't indicated that the fracture was open, he needs an open reduction and internal fixation but it doesn't say that the fracture was open or closed so what I have learned is that you go with the closed. If it is closed vs open for the procedure I would think it would cost more to open a him to do the reduction and fixation due to if it was open and that procedure was done. Does that make sense??? So I would think 820.20, because 821.00 says unspecified~but you know the location and 821.39 is basically unspecified and you know the location.

That's my thought....can anyone confirm or correct me??_


----------



## 007CPC (Sep 21, 2008)

*E code!*

Don't forget an E code explaining how the bone was fractured.


----------



## lavanyamohan (Sep 21, 2008)

Lekishak said:


> Pt. comes into hospital from nursing home 1 week after a fall for an open reduction and internal fixation of her trochanteric fracture of the femur. Which ICD 9 code should I use? I chose the 820.30 and was incorrect. The other codes given were 820.20, 821.39, 821.00. They want the most specific code for the higher reimbursement. Please help. It's concerning HCC coding.



Hi,
I feel 821.39 will help you better-


----------



## Lekishak (Sep 21, 2008)

*ICD 9 codes*

Thanks for all of your help. The correct code to use is 820.20.


----------

