• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

ICD 9 for fracture of femur

Lekishak

Networker
Messages
67
Location
Atlanta Perimeter
Best answers
0
Pt. comes into hospital from nursing home 1 week after a fall for an open reduction and internal fixation of her trochanteric fracture of the femur. Which ICD 9 code should I use? I chose the 820.30 and was incorrect. The other codes given were 820.20, 821.39, 821.00. They want the most specific code for the higher reimbursement. Please help. It's concerning HCC coding.
 

pharmon

Guru
Messages
131
Best answers
0
Was the fx open at the time she arrived? Thats an open fx code you are using. The open reduction is where they are opening the fx to fix it. So you have a closed fx and thats probably why they are rejecting. Try 820.21 for closed.
 

KellyCPC

Expert
Messages
359
Best answers
0
I agree with the above poster. You cannot assume that originally it was an open fracture.
 

amolson1325

Networker
Messages
82
Location
Bradenton, Fl
Best answers
0
I'm glad I'm on the right track...this is what I posted on the other (student forum) thread earlier~

I don't have much experience with reimbursement yet...so someone else probably should jump in. But from the scenario you are giving with those codes it dawned on me that it doesn't indicated that the fracture was open, he needs an open reduction and internal fixation but it doesn't say that the fracture was open or closed so what I have learned is that you go with the closed. If it is closed vs open for the procedure I would think it would cost more to open a him to do the reduction and fixation due to if it was open and that procedure was done. Does that make sense??? So I would think 820.20, because 821.00 says unspecified~but you know the location and 821.39 is basically unspecified and you know the location.

That's my thought....can anyone confirm or correct me??
 

007CPC

Guest
Messages
302
Best answers
0
E code!

Don't forget an E code explaining how the bone was fractured.
 
Messages
222
Best answers
0
Pt. comes into hospital from nursing home 1 week after a fall for an open reduction and internal fixation of her trochanteric fracture of the femur. Which ICD 9 code should I use? I chose the 820.30 and was incorrect. The other codes given were 820.20, 821.39, 821.00. They want the most specific code for the higher reimbursement. Please help. It's concerning HCC coding.
Hi,
I feel 821.39 will help you better-
 
Top