# Open Treatment



## velmaperales-Diaz (Apr 16, 2016)

Open reduction refers to cutting of the skin to fix a fracture?

Does open treatment refer to the same thing?


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## Fahad.Ogagang@MiraMedGS.com (Apr 17, 2016)

*treatment*

open treatment means treating for an open fracture, reduction is a type of surgical treatment for fracture whether close or open, you shouldn't correlate them as the same. open treatment is a broad term.


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## mitchellde (Apr 17, 2016)

Open treatment can be applied to a closed fracture as well as an open fracture.  There are many serious closed fractures that do require open treatment.  The code book also states that even making an incision distal to the closed fracture site to insert an implant such as an intermedilliary nail, is to be coded as open treatment.


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## Fahad.Ogagang@MiraMedGS.com (Apr 17, 2016)

*Cpt*

Open treatment is a common terminology for C.P.T. which I am not familiar with, sorry for my mistake, Open treatment is the same with open reduction. "PCS only coder"
this can be use on both open and close fracture
example of open treatment for radial/ulnar fracture:

Open treatment of radial shaft fracture, with or without internal or external fixation (25515)
Open treatment of radial shaft fracture, with internal and/or external fixation and closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation), with or without percutaneous skeletal fixation (25525)
Open treatment of radial shaft fracture, with internal and/or external fixation and open treatment, with or without internal or external fixation of distal radioulnar joint (Galeazzi fracture/dislocation), includes repair of t (25526)
Open treatment of ulnar shaft fracture, with or without internal or external fixation (25545)
Open treatment of radial and ulnar shaft fractures, with internal or external fixation; of radius OR ulna (25574)
Open treatment of radial and ulnar shaft fractures, with internal or external fixation; of radius AND ulna (25575)
Open treatment of extraarticular distal radial fracture or epiphyseal separation, with or without fracture of ulnar styloid, with or without internal or external fixation (25607)
Open treatment of intraarticular distal radial fracture or epiphyseal separation with internal fixation of two fragments (25608)
Open treatment of intraarticular distal radial fracture or epiphyseal separation with internal fixation of three or more fragments (25609)
Open treatment ulnar styloid fracture (25652)


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## mitchellde (Apr 18, 2016)

Open treatment is a common terminology for C.P.T. which I am not familiar with, sorry for my mistake, Open treatment is the same with open reduction. "PCS only coder"
I am not sure what you mean by this but you can have a closed reduction with open treatment even in PCS coding.


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## Fahad.Ogagang@MiraMedGS.com (Apr 19, 2016)

*how?*

close reduction uses external approach
open treatment uses open approach
you can't code close reduction using an open approach unless the provider decided to change the operation from close to open
do you mean close fracture using open treatment?
i did agree that open treatment can be use on both open and close fracture but not on close reduction, it will be no longer a close reduction if you open the site to reduce the fracture


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## mitchellde (Apr 20, 2016)

If you perform a closed reduction, and the make an incision to insert an intermedilliary nail.  That is a closed reduction with open treatment.


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## Fahad.Ogagang@MiraMedGS.com (Apr 20, 2016)

*Incision?*

that will not be a close reduction, if the provider did an incision then a different approach has been made it could either be percutaneous for a small incision or an open approach, always remember that intermedilliary nail is a Internal Fixation device so the procedure will not become close.

A Closed reduction is a procedure for putting the pieces of a broken bone back into the right position without surgery. Incision with an insertion of intermedilliary nail is a type of surgical procedure. You don’t need plates, pins, or screws to help hold the pieces of bone in place if you are doing a Closed Reduction procedure.

Closed reduction refers to manipulation of the bone fragments without surgical exposure of the fragments. Incision will surgically expose the site of fracture. 

http://medical-dictionary.thefreedictionary.com/closed+reduction
open reduction is a reduction of a fracture or dislocation after INCISION into the fracture site.
closed reduction- the manipulative reduction of a fracture or dislocation without incision.

try researching what close reduction means, here are some of the site you could check:
http://www.summitmedicalgroup.com/library/adult_health/aha_closed_reduction_of_a_fracture
https://en.wikipedia.org/wiki/Reduction_(orthopedic_surgery)


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