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Thread: Open fracture resulting from a crush injury

  1. #1
    Join Date
    Apr 2007

    Default Open fracture resulting from a crush injury

    AAPC: Back to School
    I recently had a medical record where the patient crushed their finger at work which resulted in an open fracture to the middle finger. I coded the crush injury as the first dx with the open fracture listed second and the open wound as the third code...is that correct? I was told that i should code the fracture first but I disagree with that. Any advice would be very helpful!!!

  2. #2

    Default Principle Diagnosis


    While selecting principle diagnosis ,As per ICD guidlines- that principle diagnosis should be the circumstances of the admission, the therapy provided, the tabular list or the Alphabetic index indicate otherwise. ( In page #26 of ICD book 2010)

    In your scenario the therapy is going to be provided for Fracture only , example fracture care will be given . So my opinion also to code Fracture as primary.
    Please tell us for what reason you are disagree with giving fracture as primary. Still giving cursh injury as a primary diagnosis is not going to be a great error.


  3. #3
    Join Date
    Apr 2007


    Thanks for your response!

    To answer you question, I initially was going to code the fracture but when I looked up the code (Page 287 in ICD 2010 and page 281 in ICD 2011) it has a tip listed. It states that if phalangeal fracture(s) are due to crushing injury, sequence that code (927.3) first. Is that not something I should follow? Also BWC on this claim will allow codes 927.3 816.02 and 883.0 and the injury clearly states this to be an open fracture (816.12).

    Thanks again!

  4. #4

    Default Open fracture resulting from a crush injury


    I agree with you , Now only i am looking that guidline in the book . We need to give Crush injury first followed by Phalanx fracture, if the fracture is due to crush injury.

    Thanks for updating me

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