Hi,
When you check the alphabetic index in ICD 9 CM,
Main term Avulsion
Sub term Fracture : see fracture by site
Avulsion is an open wound included in Fracture, which doesn't mean that the fracture is open.
see the note below:
"Closed" includes the following descriptions of fractures, with or without delayed healing, unless they are specified as open or compound:
comminuted
depressed
elevated
fissured
greenstick
impacted
linear
simple
slipped epiphysis
spiral
unspecified
"Open" includes the following descriptions of fractures, with or without delayed healing:
compound
infected
missile
puncture
with foreign body
And when you check the main term fracture in the book, you can see the "avulsion" in brackets (non-essential modifiers), which mean a simple avulsion does not affect the code assignment.
Here you can code only the fracture closed.
Hope it helps!
Thara L CPC H
