Wiki 27826 or 27828

RebeccaMoney

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Need help determing whether this surgery is 27826 (fibula only) or 27828 (tibia & fibula).
The procedures performed shows ORIF, left pilon fracture w/fixation of the fibula. However, the Dr gave me 27828. Here is a portion of the operative report.
...A longitudinal incision was placed over the posterolateral aspect of the ankle between the Achilles tendon border and the fibula. The fracture was reduced and held provisionally with the K-wires. The proximal two holes were drilled with the locking screws and distal three holes were drilled with nonlocking screws. Attention was taken to the fibula where dissection was carried out to the posterior aspect moving the peroneal tendons medially. The fibula was noted to have some callus formation, this was broken down with a rongeur. The fracture was then mobilized using a Freer and debris was removed. The fracture was then reduced and held with a reduction clamp. A posterior buttress placed and secured with nonlocking screws to be proximal to distal. Vitoss graft was prepared on the back table and spread evenly with the fibula and distal tibia. The subcutaneous tissue was then closed.
Thank you,
 
It's possible that by doing an open reduction of the fibula, that it indirectly helped reduce a tibia fracture the pt had (if the tibia was also fractured for this pt, just guessing). However, either way it would be bundled into 27826 since he didn't do any open or closed work on the tibia directly, based on the description you gave.
 
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