Orthopedic Coding Alert
CCI Bundling Uniplane, Fracture Codes Contradicts Guidelines
Code 20690 (Application of a uniplane [pins or wires in one plane], unilateral, external fixation system) has been bundled with many of the fracture treatment codes that do not include the language with or without external fixation.
This edit contradicts American Academy of Orthopaedic Surgeons (AAOS) guidelines, which suggest that 20690 can be coded separately from most other surgeries.
For example, AAOS specifically notes in its Complete Global Service Data for Orthopedic Surgery guide that 27532 (Closed treatment of tibial fracture, proximal [plateau]; with or without manipulation, with skeletal traction) excludes 20690.
Coders should consult their carriers on this issue: Medicare and some private payers will take these edits into account, while other carriers will cede to the AAOS guidelines.
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