Wiki ICD-9 code for "loss of reduction of fracture"

[twosmek]

I have a continuing problem where a patient has a fracture, closed treatment is done. Patient returns for follow up and ends up needing another surgery because there is a loss of reduction of the fracture. My questions is how do you code this. Do you just use the after care code. do you recode the fracture. Example for a distal radius fracture that is in a global for fracture care and is requiring additional procedures due to a loss of reduction, do you code it as: V54.12 or 813.42? or both? Any ideas?

 

[mitchellde]

look at malunion or non union of fracture.

 

[twosmek]

I thought that too however, the definition of

Malunion is "the joining of the fragments of a fractured bone in a faulty position, forming an imperfect alignment, shortening, deformity, or rotation."

and Nonunion is "failure to unite, as a fractured bone that fails to heal completely, diagnosis of nonunion is established when a minimum of 9 months has elapsed since the injury and the fracture site shows no progressive signs of healing for a minimum of 3 months and is not complicated by a synovial pseudoarthrosis."

neither really truely fit although malunion is the closest.

 

[twosmek]

Still would like some opinions on what you would code this as.. I run into it a lot where they try conservative treatment then the fx loses reduction and needs to go in and have surgery. Usually within a few weeks of initial treatment so no real healing has taken place....Would I just use the fx icd-9 code again. What is everyone else using!!!

 

[megstone]

I've always used the inital fracture diagnosis but ran across this thread when I was searching to see if I'm correct also.