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Orthopedic Coding Alert

READER QUESTIONS :

Don't Assume Open Fractures Mean Open Care

Published on Sat Jul 04, 2009

Question: Our orthopedic surgeon documented fracture care for an open scapula fracture, and our coder automatically assigned the open fracture care code, but I didnt think open fractures always required open treatment. Who is right? Alabama Subscriber Answer: An open fracture occurs when a patient breaks his bone and the skin, and has an open wound down to the fracture site. For such a fracture to the scapula, for example, youd report 811.1x (Fracture of scapula; open). Many coders mistakenly assume that open fractures require open treatment, in which the physician makes a surgical incision to treat the fracture. If the orthopedist performs open fracture care at the scapula, you should report 23585 (Open treatment of scapular fracture [body, glenoid or acromion] includes internal fixation, when performed). But you should not assume that this code is accurate just because the physician documented an open fracture. Physicians can address open fractures [...]
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