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25608 vs 25609
I'm looking for an answer as to what defines a fracture fragment with these two codes. When there is a fracture one could say there is always two fragments one end of the bone and then the other that is broken off. So my surgeon and I are looking for an answer as to what a "fragment" refers to... a piece that has broken would be one fragment and then if there are two pieces broken that would qualify for the two or three?
I have found no definitive articles that address this question. Your advice would be greatly appreciated.
Chris Honkala, CPC
re: 25608 vs 25609
these 2 codes are referring to the fragments being Internally fixed
this is the lay descriptions for the codes
25607-25609 ( 25607, 25608, 25609)
The physician makes a 7.5 cm longitudinal incision along the anterolateral aspect of the distal forearm. The physician exposes the fracture by dissecting between the planes of muscles and tendons of the lateral wrist area while protecting the median nerve. The pronator quadratus muscle is severed from the radius. The physician reduces the fracture or separation. A small T-plate is fixed to the proximal fragment with one or two screws. Usually no screw is inserted through the distal part of the plate since it acts as a buttress and helps hold the fracture in reduction. Direct visualization and separately reportable x-rays are used to confirm correct reduction and restoration of the joint surface. The pronator quadratus is replaced at its origin on the radius. The incision is repaired in layers using sutures, staples, and/or Steri-strips. The arm is immobilized in a cast.
25607 for open treatment of the fracture with internal fixation;
25608 for fracture repair in which two fragments of bone in the joint receive internal fixation;
25609 for fracture repair in which three or more fragments of bone in the joint receive internal fixation.