Wiki Open Fracture-I'm hope this

[tinaval]

Hello-

I'm hope this is not a stupid question. We have a patient that has a open fx, index finder distal phalanx. Our surgeon took the patient to the OR to do a debridement. She is billing 11012 which is fine but nothing was done to the fracture, she didn't have to manipulate or use any internal devices. I feel like she should still be able to bill for the fracture but since she didn't do anything to the fx I don't know if billing the open fx code would be right. And the closed fx care doesn't seem logical since it was a open fx.

Any help would be appreciated.

Thank you,

 

[jmcpolin]

Does the doc apply a cast or splint?

 

[tinaval]

She applied an aluminum splint immobilizing the DIP joint in extension.

 

[desertsteph65]

Would 26765 work?? It gives the option of with internal fixation, when performed

 

[tinaval]

I was thinking of billing that code but the description says the "physician performs a open reduction", but since our physician didn't reduce the fx I wasn't sure if it would be appropriate to bill. The physician only did a debridement of an open fx, which I'm billing 11012 since she went down to the bone. Other than the debridement she didn't do anything else to the fracture. But it seems like she should still be able to bill something for the fracture but I could be wrong. Closed treatment doesn't sound appropriate since the dx would be open fx.

 

[cindystringfellow]

I work in an ortho office and you can bill closed treatment on an open fracture. We do it all the time, especially for fingers. The debridement would also be billable.
Hope this helps

 

[tinaval]

Thank you, that helps a lot.

 

[caromissunc1]

I totally agree with Colmsted. I was an orthopedic surgical tech. for 21 years before I became an orthopedic coder. An open fracture may indeed be treated closed. You should code for the debridement as well as the code for closed treatment of a distal phalanx fracture. Just make sure that your ICD-9 code is listed as an open fracture.