Wiki Would I be correct to only code the manipulation or does this qualify for an adjustment?

[ahodge90]

I have a case where a provider had a op Bilmalleolar fx that had an ex fix applied on a different date of service. My provider went back in to perform a debridement on that fx and then he loosened the ex fix to perform a manipulation.
To me, it seems like this would be coded as a manipulation instead of the ex fix adjustment, only because the provider was the one that caused that ex fix to become loose. But it sounds like the provider is thinking this would be an adjustment.

I looked for something to guide me but I am not finding anything that really defines that this would qualify as an adjustment.
Any advice is appreciated!

 

[amyjph]

It's tough to say, I think we would need to see the details of what exactly was done. What did the debridement involve superficial or deeper? How come he had to manipulate it? Did the patient bear weight accidentally? Are they waiting for swelling to go down from a prior open fx before definitive fixation? What caused the fracture to have to be manipulated? Would he have had to adjust the ex-fix otherwise?