Crush injury of foot, fracture care

fltbaroque

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We have a patient who had the following injuries:
Open fracture distal phalanx right great toe
Open fracture distal phalanx right second toe
Closed fracture distal phalanx right third toe
Closed fracture distal phalanx right fourth toe

Our physician performed irrigation and debridement and closure for the two open fractures. He wants to charge fracture care for the two closed fractures.
Can fracture care be charged for the two open fractures as well? There was no fixation involved, only I&D and closure.

This is a worker's comp case.

Thanks in advance,
Tobi Chandler, CPC
 

CodingKing

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28490 for Closed treatment of great toe fracture
28510 for Closed treatment of fractures of other than great toe

28490-T5
28510-T6
28510-T7
28510-T8
 
Last edited:

shecodes

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It's worth noting that if this payer follows NCCI guidelines, only one fracture treatment CPT should be reported -

Excerpts from NCCI guidelines -

If a single cast, strapping, or splint treats multiple closed fractures without manipulation, only one closed fracture treatment without manipulation CPT code may be reported.

Thus if multiple closed fractures occur in an area that would have been treated with a single cast, strapping, or splint, only one CPT code for closed fracture treatment without manipulation may be reported.
 

fltbaroque

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Thank you, I appreciate the input!
However, I agree with CodingKing because the description of the fracture care codes for phalanx fractures states "each".
 

CodingKing

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Thank you, I appreciate the input!
However, I agree with CodingKing because the description of the fracture care codes for phalanx fractures states "each".
If they follow NCCI, it overrides code description. I don't have any experience with workers comp but there have been some posts around here stating that some workers comp doesn't follow NCCI.
 
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