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Orthopedic Coding Alert

Diagnosis Provides Clues to Correct Coding

Published on Sat Jun 06, 2009

Keep these 5 items in mind. Per ICD-9-CM, diagnosis codes for fractures are assigned by the open versus closed definition, which is the physical state of the fracture when first presented for repair. A fracture not indicated as closed or open should be classified as closed. Open or Closed? Dont recognize a term as open or closed? Check out these key words: Open (with or without delayed healing): Compound, infected, missile, puncture, with foreign body. Closed (with or without delayed healing): Comminuted, depressed, elevated, fissured, fracture NOS, greenstick,impacted, linear, simple, slipped epiphysis, spiral. Catch: The terms condyle, coronoid process, ramus, and symphysis indicate the portion of the bone fractured, not the name of the bone involved. Code acute hip fractures in the 800-829 series while the patient is receiving active treatment such as an emergency room encounter, initial physician treatment, or surgical repair. Watch for multiple injuries and combination categories. [...]
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