Orthopedic Coding Alert

Question: If a surgeon does not indicate whether an ex-fix is uniplanar or multiplanar, is it possible to discern which type was used from the description of the procedure or the components used (e.g., Schanz pins, skinny wires, bars, rings, etc.)?


New Jersey Subscriber

Answer: Most of the time, yes. You can rest assured that the surgeon used a multiplanar fixator if he documents that he used rings or skinny wires.

You should report 20692 (Application of a multiplane [pins or wires in more than one plane], unilateral, external fixation system [e.g., Ilizarov, Monticelli type]) for multiplane fixator applications.

Surgeons usually use Schanz pins with uniplanar fixators, but occasionally with multiplanar fixators as well. If the surgeon documents use of bars or a hinged fixator, you should ask him whether he used a uniplanar or multiplanar fixator, because surgeons use bars and hinges with both types of fixators.
 
If you determine that the orthopedist applied a uniplanar fixator, you should report 20690 (Application of a uniplane [pins or wires in one plane], unilateral, external fixation system).