tci ED Coding & Reimbursement Alert - 2005 Issue 5

Reader Questions: List Worst Fracture First

Question: Which diagnosis code should I list as primary when a patient has multiple fractures? Pennsylvania Subscriber Answer: Report any fracture that is open or complicated by debris as the primary diagnosis. If you have multiple fractures that fall into that category - or none at all - you should report the fracture for the largest, longest bone first.For example, you should report a pelvic bone fracture (808.2, Pubis, closed) before an ulna bone fracture (813.01, Olecranon process of ulna), unless the ulna fracture is open or complicated by debris (813.11, Olecranon process of ulna...

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