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Q&A: If a resident had a neck fracture with a hip replacement, would we code the aftercare for the joint replacement as the primary code?

By Carol Maher, RN-BC, CPC, RAC-MT - January 23, 2019

Question: If a resident had a right femoral neck fracture with a hip replacement, would we code the aftercare for the joint replacement as the primary code?

Answer: When a resident has had a joint replacement after experiencing an acute fracture, we are NOT allowed to code the aftercare of joint replacement.  The ICD-10-CM Manual and RAI User’s Manual both instruct us that we must code the acute fracture code with the appropriate 7th character to show the subsequent encounter of care (aftercare).  The 7th character shows that we are providing the aftercare of the acute fracture during the healing process.  This would include the therapy services and nursing services during the fracture and surgical recovery.



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