tci ED Coding & Reimbursement Alert - 2004 Issue 2

Reader Question: Don't Confuse Open Fracture With Open Treatment

Question: What constitutes an open fracture, and what does its care include?         Alabama Subscriber Answer: An open fracture is one in which the skin is broken in addition to the bone, and there is an open wound down to the fracture site. For such a fracture to the scapula, for example, you'd report 811.1x (Open fracture, scapula).  Many coders confuse this term with open treatment of a fracture, in which the physician makes a surgical incision to treat the fracture. As CPT states in its introduction to the...

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