# Primary dx code for patient S/P ORIF



## ct@yahoo.com (Nov 26, 2018)

Good morning,

I have a scenario where the patient is being seen in a skilled nursing facility for subacute rehabilitation s/p fall where he fractured his left femur. He underwent an open reduction internal fixation (S/P ORIF). I am looking for some insight as to what code to use for the primary diagnosis? I want to use S72.142D-Displaced intertrochanteric fracture of left femur, subsequent encounter for closed fracture with routine healing
I also am looking at Z87.81-Personal history of (healed) traumatic fracture with Z96.7-Presence of other bone and tendon implants but I do not think I can use these Z codes as a primary diagnosis? Any help is much appreciated.

Thank you


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## RyanRaichCPC (Nov 26, 2018)

Typically when I am billing post-operative encounters for fractures I use the appropriate S code as you have chosen as the first diagnosis, with Z48.89 and/or Z96.7.  You are correct that the Z codes cannot be first listed; I use them as secondary/tertiary diagnoses.  Hopefully this helps.


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