Aapc icd10 displaced inquiry

Meljmichon

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I was reading the Coding Traumatic Fractures paragraph in Chapter 19 on page 1075 on the ICD10 complete code set 2016 book and it indicated the following: A FRACTURE NOT INDICATED WHETHER DISPLACED OR NOT DISPLACED SHOULD BE CODED TO DISPLACED. This was something that i was told to undercode if we are not provided with enough description of the diagnosis. Can someone please explain why we would indicate the Fracture as closed if not indicated as closed or open but then choose to indicate as displaced if not indicated?

Thank you
Melanie
 

AlanPechacek

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In coding for Acute Fractures (S Codes) there are many "required" descriptors of the fracture that should be documented by the physician in order to get to the most accurate, i.e. "specific," code. However, there are 2 Default Codes in the system: Open vs Closed, and Displaced vs Non-displaced/Undisplaced. "Closed" is the Default for the issue of Open vs Closed, i.e. if the documentation does not clearly designate the fracture as being open or closed, Closed is used. In other words, if the notes don't say "Open," then it is assumed to be "Closed." The same "rules" apply to the Displaced vs Non-displace/Undisplaced issue. If the documentation does not clearly state the fracture to be "Non-displaced/Undisplaced" then it defaults to "Displaced." Again, it is assumed to be "Displaced" unless documented otherwise.

Hopefully this helps solve your dilemma.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 

CodingKing

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Guidelines give the defaults even if its "undercoding" the diagnosis. The guideline was decided based off the most common scenario. The issue is with the provider who needs to be more specific on open vs closed, displaced, vs non-displaced. Maybe physician education is needed so you can code correctly. These are things that have to come into their mind to fully evaluate and treat a fracture, they just fail to document the specifics.

For example:

Patient presents with fracture of XYZ

vs

Patient presents with Open fracture of XYZ

Its just one extra word they need to use for proper coding.
 

Meljmichon

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Thank you

Thank you for your responses. Physician Education is clearly necessary to make our jobs a lot easier.
 
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