Fracture and dislocation treatment

SydneyO

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Does anyone know if we can code a closed reduction of both a fracture AND dislocation at the same site? It looks like the codes I am considering are not bundled, but I'm still not sure if it is technically correct to report both...

The doctor dictated a closed reduction and percutaneous fixation of metacarpal dislocation (26676) and closed reduction and percutaneous fixation of MCP fracture of right small finger (26608). Dx is "baby Bennett's fracture dislocation right small finger metacarpal" S62.316A and S63.064A.

And it's not clear in the body of the OP report if those were two separate reductions. It says "A closed reduction of the fracture dislocation was performed by pulling traction on the ring and small fingers and pushing from dorsal to volar at the CMC joint. Fracture reduction was checked in PA and lateral views with mini C arm fluoroscopic imaging. The X-ray images demonstrated excellent reduction of the fracture dislocation of the CMC joint of the right small finger. Next, 3 percutaneously placed K-wires were placed across the fracture from a ulnar to radial direction."

Any suggestions? Thank you! :)
 

jfolz

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Fractures trump dislocations

I think fractures trump dislocations. We code a lot of Lis Franc injuries of the feet at our center and when coding those, they are almost always a mix of fractures and dislocations. In correcting the anatomical positions of the feet in order to fix the fractures, you are inadvertently also resetting those joints and so we do not code them separately.

This is a great topic and I do hope some more people toss in their opinions or share their knowledge...
 

SydneyO

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Thank you so much for your feedback! That's what I was thinking but I wanted to make sure :)
 
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