![]() You will be able to include the displacement or nondisplacement, laterality, and visit type (e.g., initial encounter for open fracture, subsequent encounter with routine healing) for each injury: Once you have converted to ICD-10 (International Classification of Diseases, 10th Revision, Clinical Modification, required by October 1, 2015), you will be able to identify each fracture with a diagnosis code because of the specificity of the codes. “Right hand, second digit,” on one procedure line and F7, “Right hand, third digit,” on the second procedure line. When billing the codes to insurance, you will use ICD-9 code 816.12, “Open fracture of distal phalanx or phalanges of hand,” to represent both fingers, and you should include modifier F6, Also specify the finger with modifiers F1 through FA: ![]() If you bill the code twice, you should attach modifier -59 to the second code. CPT code 26755: “Closed treatment of distal phalangeal fracture, finger or thumb with manipulation, each” for guidance.CPT code 26750: “Closed treatment of distal phalangeal fracture, finger or thumb without manipulation, each”.For finger fractures, one of the following codes will apply: You must look for these types of notes in the procedure description in order to bill CPT code 26765 correctly.Īlmost invariably when fracture treatment is performed in an urgent care center, the biller will encounter closed treatment of the fracture. Generally, these procedures are performed in an operating room of a hospital or ambulatory surgery center. The surgeon will place a splint or brace on the digit for protection. An x-ray may be obtained to confirm the reduction of the fracture. The provider may fix the fracture using implants like a plate, screw, nail, or wire before closing the wound by suturing the skin layers together. The provider then adjusts the bone to reduce the fractured fragments or to bring the dislocated bones back to their normal alignment. The provider dissects down through the subcutaneous tissue and retracts the muscles to obtain adequate exposure of the phalanx fracture. In general, during an open fracture treatment, the provider incises the skin over the fractured bone once the patient has been appropriately prepared and anesthetized. Alternatively, the surgeon may insert an intramedullary nail or other orthopedic device for international fixation of the fracture. It includes repair with manipulation, repair without manipulation, or repair with or without traction Open treatment means that the surgeon performs an incision to expose the fracture and usually performs internal fixation. The terms closed treatment and open treatment in the CPT guidelines have been carefully chosen to accurately reflect the specific orthopedic procedure that is performed.Ĭlosed treatment specifically means that the fracture is not surgically opened (exposed to the external environment and directly visualized). A diagnosis of open fracture means that the skin has been broken traumatically, but it does not automatically require open surgical treatment, which is required for Current Procedural Terminology (CPT) code 26765. Can I bill procedure code 26765 (“Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each”) twice?Ī. We had a patient come in with an open fracture of the distal interphalangeal joint of the right index and middle fingers, ICD-9 code 816.12.
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