Orthopedic Coding Alert

Question: The physician performed an open reduction and pinning of a perilunate dislocation. What is this, and how should I code it?

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Answer: In a perilunate dislocation, all carpal bones with the exception of the lunate are dislocated posteriorly. A scaphoid fracture is occasionally associated with this injury, which is then referred to as a trans-scaphoid perilunate dislocation. Open treatment of a perilunate dislocation is coded 25670 (Open treatment of radiocarpal or intercarpal dislocation, one or more bones). If there is an associated scaphoid fracture, you should report 25685 (Open treatment of trans-scaphoperilunar type of fracture dislocation).