Radiology Coding Alert
Type I, II, or III? How to Classify Open Patellar Fractures
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.
In type I open fractures, the wound is clean and <1 cm in length. Wounds in type II open fractures are >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 (outermost layer of the bone) 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 regardless of the soft tissue damage.
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