Wiki Is it ever okay to bill for closure with an Open Fracture?

[holsonf]

There has been debate on whether or not to bill for closure with an open fracture code. Is there ever a situation where we could bill for closure (simple, intermediate or complex) with an ORIF code? We handle trauma orthopedic coding, so sometimes the open fractures are traumatic in nature. Many times we'll have a Open fracture, Debridement of the fracture site & closure of the site as well. Any thoughts on this would be greatly appreciated!!

 

[Orthocoderpgu]

not be able to bill closure very often

The closure of the wound will always bundle especially when you are billing debridement at the site of a fracture. You may be able to bill for complex closure, however make sure that complex closure is actually documented such as stents and extensive undermining. Also keep in mind that if the physician has to extend the wound which they often do, then complex closure can't be billed either.

Basically you can't charge for closure when the physician creates or extends the opening.

Hope this helps.

 

[holsonf]

Thank you so much! This has been an issue that I've been trying to find in black & white to send to the doctors. At least I can feel more confident telling them they can't bill for closure with ORIF & debridement.