Orthopedic Coding Alert

Determine if fracture is open or closed to select the right code.

As of Oct. 1, you'll have two new codes for to apply for pelvic fractures:

• 808.44 (Multiple closed pelvic fractures without disruption of pelvic circle)
• 808.54 (Multiple open pelvic fractures without disruption of pelvic circle)

Refresh Your Pelvic Circle Knowledge

Sacrum, coccyx, ilium, pubis, and ischium are the five bones that are arranged in the form of a ring to form the pelvis (see Figure 1). These bones protect the internal organs in the pelvis and provide support for locomotion. Falls, accidents, and other injures may cause fractures in one or more bones of the pelvis. You report such fractures as pelvic fractures.

When to Report These Codes?

You report either of the two codes, 808.44 or 808.54, for the pelvic fractures, open or closed, that do not disrupt the pelvic circle. Open fractures are those where the bones involved in the fracture are exposed to the exterior. Closed fractures are not exposed as the overlying skin and tissues remain intact.

Count the Fractures

Before you report either of these two codes, make sure you have confirmed that you have counted the number of fractures reported by your surgeon. The two codes, 808.44 and 808.54, apply only to multiple fractures of the pelvic bones that do not disrupt the pelvic circle. "Fractures that involve only a single bone of the pelvic circle are reported with the code that is specific to that bone. For example, a closed fracture of the ilium is reported with code 808.41 (Closed fracture of ilium). However, if the patient has fractures of the ilium and ischium without disruption of the pelvic circle, report code 808.44," Heidi Stout, BA, CPC, COSC, PCS, CCS-P, Coder on Call, Inc., Milltown, New Jersey and orthopedic coding division director, The Coding Network, LLC, Beverly Hills, CA.