hip fx vs. pelvic fx

[glm777, BSN, RN]

what should an "intertrochanteric" fracture be coded as - hip or pelvis? The hospital d/c summary says pelvic, the MD says hip. The actual xray says simply "intertrochanteric fracture".

In the RAI manual it says to code a hip fx in section I if it is a "trochanteric" fracture - doesn't say anything about intertrochanteric fx. The DON wants to code it as a pelvic fracture (sounds better than a hip fx s/p fall I guess).

What would you code it as?

[Talino]

hip fracture classifications

anatomic locations (head, neck, intertrochanteric, trochanteric, and subtrochanteric) and note whether it is intracapsular or extracapsular. femoral head and neck fractures are considered intracapsular, while trochanteric, intertrochanteric, and subtrochanteric fractures are considered extracapsular. intracapsular hip fractures frequently have complicated healing.

the x-ray result confirms the location. you would also need to add the v code in i3.

[susanthomas1954]

The trochanter is part of the hip. It's a hip fracture. It happens. And in over half the cases, the hip breaks and then the patient falls. Probable history of osteoporosis. An experienced DON knows that falls and hip fractures happen in all nursing homes.