Closed reduction and pinning of fracture. - plastic surgeon

asmonger

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I'm new to coding for a plastic surgeon. A patient opted for surgery after a healed fracture of the long finger that resulted in weakness and reduced range of motion in the finger.

The surgery consisted of a closed reduction of the long finger and then percutaneous pins were placed from the tip of the distal phalanx to the middle phalanx to support the DIP joint The pins were then cut flush to the skin.

Would there be a code that covers the above procedure for the above or would I code the closed reduction and then code the pinning?

I'm also over thinking the pinning codes. Would I code once for the pinning or for each phalanx or joint?

Thank you in advance for your input!
 

abbycat333

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This is called malunion. When you say healed fracture, I am surprised that the bone could be straightened by closed reduction. If it was a fracture that failed to completely heal, then it could be a nonunion. But the procedure you are describing is usually done for an acute fracture and you would use 26756 for that. You code percutaneous pinning according to what joint is broken or dislocated, not what bones the pin had to pass through to secure the injury. A K-wire is shot through the end of the finger, through the distal phalanx, and down into the middle phalanx to fix a dislocated or fractured DIP, for example. First, be sure about whether the fracture is acute or old, and if the latter, is it malunited or not united. And then find out how the bone was reduced, open or closed, or percu.
 
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