Lisa Bledsoe
True Blue
One of my docs wants to code 27230 for a femoral neck fracture and I want to code 27236 and here's why: (multiple attempts at pinning the fracture with fluoro were unsuccessful)..."it did not appear that we were moving the fracture. It appeared to be impacted. We decided not to proceed with too aggressive rehab for fear of damaging the blood supply. At this point...using a 15 blade scalpel, a 4-cm incision was made over the greater trochanteric area. This was carried down to subcutaneous tissue. Several bleeding vessels were identified and coagulated. The deep fascia was then divided in line with the incision. The guide for the 7.3 cannulated screw set was placed on the trochanteric region and through the femoral neck into the femoral head. Its position was checked on AP and lateral radiographs. Several small adjustments were needed but once we had this in place, another pin was placed anterior inferior to this pin and another one was placed posterior superior to this to get 3 pins in different planes of fixation. After ascertaining they were in good position, the near cortex was drilled with the cannulated drill and 7.3 short threaded cannulated screws were placed up over the drill guides until the screws were in good position..." (whew)
So, I see this as open. He says that it is not considered open unless they actually see the fracture site. I have never heard this. I am going to be taking my COSC in October, so I want to make sure I know what I'm doing.
So is this 27236 or 27230? Well, he says 27230 but if it's not 27236 wouldn't it then be 27232??????
PLEASE HELP
So, I see this as open. He says that it is not considered open unless they actually see the fracture site. I have never heard this. I am going to be taking my COSC in October, so I want to make sure I know what I'm doing.
So is this 27236 or 27230? Well, he says 27230 but if it's not 27236 wouldn't it then be 27232??????
PLEASE HELP