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Orthopedic Coding Alert

Reader Questions:

List Fracture Care Codes According to RVUs

Question: Which diagnosis code should I list as primary when a patient suffers multiple fractures?

Pennsylvania Subscriber
Answer: You should link the diagnosis codes to their associated CPT fracture treatment codes, which you should report in descending order, according to the relative value units (RVUs). List the fracture care code with the highest RVU first, and so on.

For example, you should report a closed tibia fracture (27530, Closed treatment of tibial fracture, proximal [plateau]; without manipulation, linked to 823.00, Fracture of tibia alone; upper end, closed) before you list an ulna fracture (25560, Closed treatment of radial and ulnar shaft fractures; without manipulation, linked to 813.01, Fracture of olecranon process of ulna). That's because 27530 is worth 9.70 RVUs, whereas 25560 is only worth 6.46 RVUs. You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.

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