Fracture coding
I took this excerpt from an AAPC article. Hope this helps.
"There are three major approaches to treat fractures: closed, open, and percutaneous.
?Closed treatment means the fractured bone is not exposed to the view of the surgeon.
?Open treatment means the bone is exposed by incision.
?Percutaneous treatment (aka percutaneous skeletal fixation) involves the placement of a fixative device?such as a rod, wire, or pin?across the fractured bone usually under imaging guidance.
The treatment type will not necessarily match the fracture type. For instance, an orthopedic surgeon may perform an open treatment of a closed fracture, or a percutaneous treatment of either a closed or open fracture."
"When coding for physician services for surgeries to correct fractures, pay particular attention to terms such as closed/open/percutaneous treatment and details describing the specific site (such as nasal bone, nasal septum, nasoethmoid, nasoethmoid complex, or nasomaxillary). You?ll also need to understand which combinations of terms are mutually exclusive with each of the three treatment methods. Read all CPT? descriptors carefully, noting terms such as ?open reduction with internal fixation.? Observe when certain services (such as the application of the fixative device) are included in the descriptor, and not reported separately."
http://news.aapc.com/fine-details-are-critical-in-fracture-coding/