Podiatry Coding & Billing Alert

Assigning episode-of-care seventh characters for traumatic fractures is a bit more complicated than assignment for other injuries because the episode of care provides additional information about the fracture.

The list of additional descriptors covers not only the episode of care, but also whether the doctor is treating an open or closed fracture, nonunion, malunion, or fracture sequela.

Here's a reference list of the standard acute fracture codes you'll use:

A - Initial encounter for closed fracture
B - Initial encounter for open fracture

Note: A fracture not indicated as open or closed must be coded as closed, and a fracture not indicated as displaced or not displaced needs to be coded as displaced. There are initial encounter codes for open and closed fractures, but the subsequent encounter codes do not differentiate between the two.

D - Subsequent encounter for fracture with routine healing
G - Subsequent encounter for fracture with delayed healing
K - Subsequent encounter for fracture with nonunion
P - Subsequent encounter for fracture with malunion
S - Sequela