Orthopedic Coding: Simplify Your Coding Processes For Fracture Treatment

By Author: Julia Rose
Total Articles: 89
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Orthopedic coding for fractures needs minute attention to details; else you'll easily land on the wrong code. You have to achieve the correct coding combo by following these 5 steps for fracture treatment.


Step 1: Identify the type of fracture treatment


This is the most important thing to remember as far as fracture treatment goes. For example, an open/compound fracture can be treated by closed means, or vice versa. An orthopedic surgeon may employ these fracture treatment types:


Closed treatment: The fracture site is not surgically and the treatment can be with or without manipulation and/or traction.


Open treatment: The fracture is surgically opened and visible. To code the open treatment, a surgical opening needs to be made.


Percutaneous skeletal fixation: The physician places a fixation across the fracture site, usually under x-ray imaging such as fluoroscopy, but the fracture fragments are not visible.


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... Step 2: Determine External or Internal Fixation


You also need to consider external and internal fixation when choosing a surgical fracture code. The reimbursement for fracture fixation, whether internal or external, is frequently included in the CPT code. Use codes for external fixation when external fixation is not listed as part of the basic procedure.


Step 3: Check for Separately Codeable Debridement


Consider debridement a separate procedure only when gross contamination requires prolonged cleansing, and documentation must support that an appreciable amount of devitalized or contaminated tissue is removed or carried out separately without primary closure.


Step 4: Look for Procedure, E/M Supporting Documentation


Documentation should also reflect the type of care and treatment. Key items in the initial assessment should have the neurologic and vascular status clinically assessed and documented. When reporting the global method of fracture care, an E/M service may also be reported.


Step 5: Remember to Code for Materials


With either method, do not forget to report additional supplies of casting materials. Check with payers to determine the best reporting mechanism for supplies. Documentation should also support medical necessity of any future cast application/repairs/replacement as some payers will allow only one cast application.


Get the orthopedic Coding updates on time


Watch for future changes in fracture code RVUs as they have been brought to attention by CMS. Getting the orthopedic coding updates on time will make it easy for you to code successfully for fracture treatment.


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