Medial Dislocation – Billing it Right

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing.

Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments.

On the claim you would want to report 24600 (Treatment of closed elbow dislocation; without anesthesia) for the elbow reduction. Then attach ICD-9 code 832.03 (Dislocation of elbow; closed; medial dislocation of elbow) to show the reason for the reduction) and then add the modifier 52 (Reduced services) to 24600 to show that you are not reporting a fully successful reduction.

Some physicians may choose not to bill at all for a painful procedure that isn’t successful however do include the medical necessity and documentation of the procedure to show the reason for another or more expensive procedure.

Cover yourself and make sure all your medical billing claims are thoroughly documented, this will result in better reimbursements and airtight claims from your practice and you’ll reap the rewards of a better revenue flow for your business.

View all Articles by: Kathryn E, CCS-P - Retired