Orthopedic Coding Alert

Question: The physician completed a take-down of a tibial nonunion fracture and placed an allograft. Should we report an unlisted code, or do we have other options?Florida SubscriberAnswer: You have two coding options, depending on which scenario your surgeon's documentation best reflects.Option 1: Report 27720 (Repair of nonunion or malunion, tibia; without graft, [e.g., compression technique]). The descriptor doesn't include an allograft, so append modifier 22 (Increased procedural services) to represent the extra work of grafting.Option 2: Report 27899 (Unlisted procedure, leg or ankle) and compare to 27724 in regards to reimbursement (33.81 total relative value units [RVUs] for facility or non-facility). Take a closer look at the operative notes or discuss the case with your surgeon to determine the most appropriate tactic.