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Orthopedic Coding Alert

READER QUESTIONS:

Clarify Your Diagnosis for Cast Complication

Published on Sun May 03, 2009

Question: One of our doctors performed a closed reduction on a patients left wrist and applied a cast on 2/19/2009. The patient came into the ER on 3/02/2009 because of swelling, and another one of our doctors had to change the cast. What ICD-9 code should I use? Tennessee Subscriber Answer: You wont find any specific complications due to cast code. You might try using 998.89 (Other specified complication of procedures, not elsewhere classified).Private payers may pay for the ED visit with the complications diagnosis. Another option is to go with 729.81 (Swelling of limb) in addition to the appropriate aftercare for healing fracture ICD-9 code. The reason is the encounter involved a cast change and the physician indicates the patient still has a healing fracture. Therefore, youll use a V54.xx code. For instance, use V54.12 (Aftercare for healing traumatic fracture of lower arm) for a traumatic fracture or V54.22 [...]
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