06.01.08
June Question of the Month
Q: Pelvic fractures are coded much differently in AIS 2005. What are the most specific AIS codes for the following three different pelvic fracture descriptions?
1) Complex fractures of pelvis with comminuted fractures of superior and inferior public rami bilaterally, separation of pubic symphysis and separation of L sacroiliac joint.
2) Multiple severe fractures of pelvis.
3) Non-displaced fracture R sacrum. Fracture of anterior column of R acetabulum extending along R iliac bone and comminuted fracture through R sacral ala.
A:1) The involvement of the SI joint indicates partial instability of the posterior arch of the pelvis. All of the other fractures are in the anterior portion of the pelvic ring, and are not factors in the stability of the pelvis. The correct code is 856161.3.
2) Although this sounds like a potentially unstable pelvic fracture, there is not enough detail given to code it to anything more specific than 856100.2.
3) This fracture description will provide two distinct codes. In AIS 2005 the acetabulum is coded spearately from the pelvic ring. The sacral fractures do not involve the SI joint and do not affect stability of the pelvis. The correct code for the pelvic ring fractures is 856151.2. The correct code for the acetabulum fracture is 856251.2.
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