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March 12, 2021

We have a patient that was sledding with their grandchild, went to grab the child and had a twisting injury that resulted in a hip fx. Would this be in the PTOS inclusion? I don’t see a twist injury in Appendix 15.

Appendix 15 are examples for our solitary hip fracture exclusion. In order for a patient to meet this exclusion the patient must sustain a solitary hip fracture from a fall on the same level. It does not sound like from the information you provided that the patient fell. Therefore, the patient would not meet the exclusion.

Based on the information you provided, the patient should be considered for PTOS. The patient must have an injury diagnosis that falls within the ICD-10 inclusion code range AND meet another portion of the criteria (i.e. LOS, ICU admission, transfer, etc.).

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