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ICD 9 for fracture of femur

  1. #1
    Location
    Atlanta Perimeter
    Posts
    67
    Default ICD 9 for fracture of femur
    Medical Coding Books
    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.

  2. Default
    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.

  3. Default
    I agree with the above poster. You cannot assume that originally it was an open fracture.
    Kelly Long CPC, CFE
    Manager Audit and Compliance

  4. #4
    Location
    Bradenton, Fl
    Posts
    82
    Default
    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??
    Angie Olson, CPC

  5. #5
    Default E code!
    Don't forget an E code explaining how the bone was fractured.

  6. Default
    Quote Originally Posted by Lekishak View Post
    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-

  7. #7
    Location
    Atlanta Perimeter
    Posts
    67
    Default ICD 9 codes
    Thanks for all of your help. The correct code to use is 820.20.

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