ED Coding and Reimbursement Alert

Question: How can we tell the difference between an open fracture and a closed fracture?

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Answer: A closed fracture involves a broken bone that has not broken the skin. So, if there is no evidence of a breach of the skin in the encounter notes, you likely have a closed fracture claim on your hands.

Conversely, an open fracture is when the bone has punctured through the skin or there is a significant break in the skin directly over the fracture site - not an abrasion or superficial laceration.

As you might surmise, open fractures are usually quite severe, and treating these fractures often requires either surgery or a fixation device. When in doubt, ask the ED physician which type of fracture he treated.