Orthopedic Coding Alert

Question: How do I bill for both a pubic ramus fracture and a sacrum fracture?

Florida Subscriber

Answer: Whenever fracture treatment does not constitute a procedure, it can be very confusing trying to determine how to report the service(s) rendered, says Heidi Stout, CPC, CCS-P, coding and reimbursement specialist at University Orthopaedic Associates in New Brunswick, N.J., where she works with 11 physicians at three locations, representing various orthopedic specialties. In this scenario, the physician is treating both a fracture of the pubis and sacrum without manipulation. A coder can use either the appropriate level of evaluation and management code for each patient encounter or the global fracture treatment codes. In this case, the fracture code would be 27193 (closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation). If the treatment rendered is bed rest and/or limited mobility, that code would suffice for the entire fracture.