Orthopedic Coding Alert

Since the ICD-10 codes for open fracture depend upon the type of fracture, it is good to take a quick review what type I, II, and III fractures are.

Open fractures are classified as type I, II, or III depending upon the open wound. In type I open fractures, the wound is clean and <1 cm in length and in type II open fractures, the wound is >1 cm without extensive soft-tissue damage. Type III fractures have extensive loss of soft tissues. “Type III fractures are also defined as those with an accompanying open wound >5 cm,” says Bill Mallon, MD, former medical director, Triangle Orthopedic Associates, Durham, N.C.

In type IIIA, the periosteal coverage is intact despite extensive soft tissue loss and in type IIIB the periosteum is stripped and the bone is damaged. An arterial injury necessitating a repair qualifies for type IIIC irrespective of the soft tissue damage.