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kc-george

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I have a question regarding ORIF of ankle fractures. I know that one can code for orif's of ankle, be it bimalleolar, tri, etc, and the fixation of the syndesmotic screws, of the joint is disrupted/dislocated, but I have a quandry. If the docs performs what he is calling an orif of a bimalleolar fracture and repair of syndesmosis, but the second part of the bimalleolar fracture is fixed with fixation of the lateral- hence- he repairs the medial with perc pins- - would I still use 27814, and then 27829-51 or 59? - - or, would it be more accurate to unbundle the whole thing?? 27792, 27760, and 27829?? That would cover the orif of the lateral malleolus, the perc pinning for the medial, and the syndesmosis fixation.

So, in short, if bimalleolar fx is repaired with orif lateral side, but perc pinning medial side, would I unbundle, or use 27814?

I could really use some help with this one, as our otho trauma specialist he been seeing a lot of these, and it seems like he is on a role as far as planning to do an orif of bimalleolar fx, and then, fixing second part with perc pins... please-- can someone debate this out with me???!!!

Thanks so much!!
 
I would only use for the bimalleolar fx 27814 with includes a incision on the lateral and medial malleolus, so if you are using 27829 it has to has a sep. incision., My understanding is that the medial malleolus is being repaired due to a fx that has disrupted the syndesmosis.
I hope this will help!

Stacy CCA,CPC
 
It does- thank you. And I see what you are saying. And, particularly since there was no new incision used, I can see the validation in your point, especially about the syndesmosis repair. It really threw me, more than anything, the thought of using an ORIF code when he actually only repaired one side open, and the other percutaneously, but, to break it down would be to unbundle the code severely.

... thanks so much for your time in answering my question. I greatly appreciate the expertise and your time!

Casey
 
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