27766??

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Kansas City, MO
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I'm new to Ortho coding (and fairly new to coding in general) and would like some feedback on CPT code 27766 (open tx of medial malleolus fx), please. The op report states once the doctor was in the ankle, he was "able to identify the screw and nonunion fragment. Screw was removed without difficulty. After this, I was able to shell out the medial malleolar nonunion fragment. This left a significant void as the deltoid ligament was attached to the medial malleolar fragment. Decision was made to perform a deltoid ligament repair..."

I billed 27695 for the ligament repair, but can I bill for the 27766 with him just "shelling out" the nonunion fragment?
Thanks for any advice!
 

Orthocoderpgu

True Blue
Local Chapter Officer
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855
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Salt Lake North
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Keep these things in mind

The ORIF CPT codes state: "treatment of fracture..includes interal fixation when performed". So your surgeon "treated" a non-union fracture, and internal fixation is optional.

On many of the non-unions there are specific CPT codes for them. So make sure you look for that.

The ligament repair is included with the initial ORIF procedure. Wonder if the patient was hurt after the initial repair that went on to non-union?
 
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