Fee Navigator®

    Governing Rule: 6.13

    FRACTURES AND DISLOCATIONS - OPEN FOLLOWING CLOSED REDUCTION

    • 6.13.1

      If the same physician performs an open reduction following an attempted closed reduction, under the same anesthetic, only the benefit for open reduction may be claimed.

    • 6.13.2

      If the same physician performs an open reduction following an attempted closed reduction, under a different anesthetic, benefits for both may be claimed.

    • 6.13.3

      An additional 50% of the listed benefit may be claimed by orthopedic surgeons for open reduction of a fracture with demonstrated radiographic non-union at least 12 weeks from the date of the initial fracture (NUFRAC modifier).