ED Coding and Reimbursement Alert

Question: A patient came into the ED with a medial dislocation of his elbow. The physician tried to reduce the dislocation, but was unsuccessful. She did not use any anesthesia during the procedure. How should I report this encounter?

Minnesota Subscriber

Answer: If the physician unsuccessfully attempted to reduce the injury, you technically could report acode for a reduced service. On the claim:

• report 24600 (Treatment of closed elbow dislocation; without anesthesia) for the elbow reduction.
• attach ICD-9 code 832.03 (Dislocation of elbow; closed, medial dislocation of elbow) to show the reason for the reduction. [5^th digit required]
• append modifier 52 (Reduced services) to 24600 to show that you are not reporting a fully successful reduction.

Of note, many groups decide not to bill for painful procedures that were not fully successful for public reactions reasons.