Orthopedic Coding Alert

READER QUESTIONS :

Don't Assume Open Fractures Mean Open Care

Question: Our orthopedic surgeon documented fracture care for an open scapula fracture, and our coder automatically assigned the open fracture care code, but I didnt think open fractures always required open treatment. Who is right? Alabama Subscriber Answer: An open fracture occurs when a patient breaks his bone and the skin, and has an open wound down to the fracture site. For such a fracture to the scapula, for example, youd report 811.1x (Fracture of scapula; open). Many coders mistakenly assume that open fractures require open treatment, in which the physician makes a surgical incision to treat the fracture. If the orthopedist performs open fracture care at the scapula, you should report 23585 (Open treatment of scapular fracture [body, glenoid or acromion] includes internal fixation, when performed). But you should not assume that this code is accurate just because the physician documented an open fracture. Physicians can address open fractures [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Orthopedic Coding Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.