tci ED Coding & Reimbursement Alert - 2006 Issue 10

You Be the Coder ~ Sequencing ICD-9 Codes

Question: When the ED physician treats multiple fractures, which diagnosis code should I list first on the claim? Our doctor recently treated a patient with the following fractures: closed fracture of the scapula, open fracture to the sternal end of the clavicle, and closed fracture of the pubis. But I don't know which ICD-9 code to list first. Any suggestions?Washington SubscriberAnswer: You should report the fracture that involved the most treatment as the primary diagnosis on the claim. That means diagnosis coding for any fracture that is open, or complicated by debris, should be listed before you code...

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