Orthopedic Coding Alert

Question: I’m having trouble keeping everything straight in the clavicular fracture repair code set. Could you give me a few tips on how to differentiate between these codes and use them correctly?

Louisiana Subscriber

Answer: Knowing the difference between open and closed treatment might appear to make this an open and shut coding case. You can’t, however, just rely on these treatment smarts to guide you to the proper clavicular fracture repair code; there are shades of difference throughout the clavicular fracture fix set, which stretches past 10 codes.

• 23500 (Closed treatment of clavicular fracture; without manipulation)
• 23505 (… with manipulation)
• 23515 (Open treatment of clavicular fracture, includes internal fixation, when performed)

Anatomy of the fracture: You’ll also need to know the difference between open closed treatment to code correctly. In short, closed treatment occurs when the surgeon does not open the fracture site; they may or may not use manipulation during a closed treatment.

For open treatment, the surgeon will open the fracture site, and typically use plates, pins, or screws to realign or reattach bone fragments.