Emergency Department Coding: Critical Care, Lacerations, Burns and Fractures
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Fix Your Fracture Care Claims in 3 Simple Steps to Avoid Errant Code, Postop Overlap
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You’ll also need to determine open/closed before coding the treatment
1. Check if Fracture Is Open or Closed
The first thing you’ll need to deduce from fracture care documentation is whether the physician treated an open or closed fracture.
Your ED physician will typically treat closed fractures, explains Michael Lemanski, MD, ED billing director at Baystate Medical Center in Springfield, Mass. He may or may not need to perform reduction to treat a closed fracture.
“An open fracture occurs when the bone has punctured through the skin, or there is a significant break in the skin directly over the fracture site — not just an abrasion or superficial laceration,” says Sharon Richardson RN, compliance officer with Emergency Groups’ Office in Arcadia, Calif.
“This makes the fracture more complex, because it is usually angulated, and needs reduction,” Lemanski explains of open fractures.
Catch this: “Open fracture treatment is rarely done in the ED; these patients are usually taken to the OR, as there is significant risk of infection, and open fracture treatment usually requires some type of fixation device,” according to Richardson.
ED scenario: A pedestrian is struck by a motor vehicle while crossing the street; an exam reveals her right ankle is broken and the bones are protruding through the skin. The ED physician will stabilize the patient and ultimately the orthopedist...
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