Cracking the Code
Sequencing of a Periprosthetic Fracture
What is a periprosthetic fracture? Periprosthetic fractures occur when there is a fracture around an orthopedic implant, whether a replacement or an internal fixation device. They are associated with significant morbidity and increased mortality in some cases. All periprosthetic fractures require some form of treatment. Stable nondisplaced fractures could only require protected weight-bearing or cast/brace immobilization as well as pain medication. However, most unstable peri-implant fractures require surgical stabilization, implant replacement, or both to restore function.
Concerning the coding sequencing of a periprosthetic fracture and the actual fracture itself, instruction is quite limited but can be found in a 2016 Coding Clinic. This coding clinic sites, “if the reason for the admission/encounter is the fracture, the specific type of fracture (traumatic or pathological) should be sequenced first and the periprosthetic fracture code should be sequenced as a secondary diagnosis code.”