Orthopedic Coding Alert
Reader Questions:
And/Or Can Make a Big Difference in Surgical Coding
Published on Wed Apr 06, 2022
Question: Encounter notes indicate that the surgeon performed repair of a nonunion in a patient’s left radius and left ulna. There was no mention of autograft. Should I report 25400 x 2? Answer: You shouldn’t report 25400 (Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique)) at all. Why? There’s a code for nonunion repair that encompasses both of the physician’s actions described in your scenario. On the claim, report 25415 (Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique)) for the radial and ulnar repair. Remember to append modifier LT (Left side) to 25415 to indicate the laterality of the surgery.
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Orthopedic Coding Alert
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And/Or Can Make a Big Difference in Surgical Coding
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