Wiki Fracture help

[Attersgal]

We are having a debate as to how to correctly code fracture follow-ups during the healing stage. Would you continue to code the fracture until it is specified that 'healed'; code as aftercare using the V-code; or combine as both using first the V-code followed by the appropriate fracture code?

 

[mitchellde]

You only code the V code for healing fracture once the fracture has been treated. This is well covered in several coding clinics, that state once the fracture has been actively treated you no longer code the acute fracture code, you use the V code for healing fracture. The acute fracture codes should never be used for follow up encounters as they indicate a new fracture that has not been treated. These are patient diagnosis, therefore the codes we select must match the patient condition for that specific encounter. If you continue to use acute fx codes after it has been treated, then the patient will have a greater risk associated to them by the payer and can raise their premiums as a result. You must always be correct in the assignment of the dx code as it fits the patient for the encounter. So it will be a V code for healing fx , or a V code for healed fx, or a complication code after the fx has been treated, it will never be that acute fx code again until the patient fractures that bone in a separate incident.

 

[Attersgal]

Thanks for the clarification. That had been the argument here, however; we had a supervisor that was adamant that we code the fx until it was stated that it was healed.

 

[mitchellde]

Well you can always use the coding guidelines to help clarify this type of argument. They state that you do not code the pre procedural condition for follow up or aftercare, in addition the coding clinics are considered the last most definitive word for correct coding information. Hopefully this will help knee this from occurring. The difference with ICD-10CM is that you will not Z codes for aftercare of injuries, instead you will use the acute injury code but the 7th character will reflect the point in time for the injury, ie initial, subsequent, sequlae