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Thread: Fracture occuring during surgery

  1. #1

    Smile Fracture occuring during surgery

    AAPC: Back to School
    Hi all,
    I have a physician who removed a total knee replacement and inserted antibiotic beads. In the process of removing the tibial component the tiba was fractured. He dictated that "care was taken to protect the tibia and preserve as much bone as possible during the extraction, but these cracks still occured".

    He is wanting to bill an ORIF of the tibia. I think this is wrong. If a fracture occured during the surgery and it was our fault that the fracture happened then we shouldn't bill for the repair, but I need something in writting before I bring this to him. I've searched Goggle, Medicare's Website, AAOs, and the Orthopedic Decisions website and I cannot find anything, but I know I've heard this before. I may not be using the correct terms to search.

    Am I right? If so, does anyone know where I can get this in writting? Thanks in advance for any help.
    Christy Brown, CPC
    Appalachian Orthopedic Associates P.C
    Johnson City, TN

  2. #2
    Join Date
    Apr 2007


    I'm not sure where this is in writing....its inbedded in my brain but I'm sure that wont help you prove your point to the doc. But you are correct, if the fracture occurred during the surgery it is inclusive of other procedures performed. You might try the National Correct Coding Guide...there are too many chapters for me to attempt to look for you.....its EOM...UGHHHHH

    Mary, CPC, COSC

  3. #3


    Thank you Mary. I hadn't even thought of checking the National Correct Coding Guide, but I will. Unfortunetly this doctor needs to see something in writting and this has been impossible to find. Thanks for the suggestion. Have a great day!
    Christy Brown, CPC
    Appalachian Orthopedic Associates P.C
    Johnson City, TN

  4. #4
    Join Date
    Apr 2007
    Columbus, Ga


    I have encountered the same thing - does anyone know of proper documentation that I can take to my physician?

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