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BILLING ORIF WITH COMPLEX WOUND CLOSURE and Debridement for open fx

R

RCURTIN

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Tewksbury, MA
Hi Everyone,

I have a physician who wants to bill a 27513 ORIF with a 11012 and a complex wound closure? It is my understanding that the closure of the wound would be included in the ORIF. Any help would be appreciated.
 
BILLING ORIF w/Debride

You would be correct - 27513 includes "closure of wound and repair of tissues divided for initial surgical exposure, partial or complete". (Per global service data)

Good luck :)
 
When I attended a Zupko ortho conference I asked this question. The answer I received was at the site of an OPEN fracture a simple & intermediate repair is bundled. However, if it's a complex repair then yes the provider can bill for it. The repair must meet the guidelines for complex per the CPT book. It also states that anything 1 cm or less see simple or intermediate repair. Hope this helps.
 
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