Open multiple fractures involving both lower limbs, lower with upper limb, and lower limb(s) with rib(s) and sternum

This code signifies a severe traumatic injury involving multiple open fractures affecting both lower extremities, or a combination of lower limb fractures with upper limb fractures, or lower limb fractures with rib and/or sternal fractures. "Open" indicates that the skin and soft tissues overlying the fracture site are compromised, exposing the bone.

This code is appropriate for polytrauma patients presenting with complex fracture patterns as described. Documentation should clearly specify the open nature of the fractures and precisely identify the involved anatomical sites, such as bilateral tibia/fibula fractures with an open humerus fracture, or open femur fractures with associated rib fractures.

• Always ensure the documentation explicitly states "open" for all fractures to justify this code.
• Do not use this code if all fractures are closed; a different code for multiple closed fractures would be more appropriate.
• Carefully review the operative report and imaging studies to confirm the exact anatomical locations and open status of all fractures.