Wiki Coding help please

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adamsc

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I would appreciate help with coding this op note please. I really appreciate it.
 

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FYI: When you have something like this you really should code it to the best of your ability first and then ask for either help or confirmation. That way we can see what your thought process is.
 
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Code 27641 is a good code. You could also consider 27607 which is labeled more towards the distal end since it includes the ankle as well, but 27641 does not exclude the ankle. Flip a coin? My question is, was the non-union treated? If so you could consider 27726-52 since internal fixation was not used. This is where provider education may come in. The documentation states that there was "unhealed (fracture) fragments" in the "area" that was debrided and excised. Was this treatment for the fracture, it seems so, at least partially. Was infection (osteomyelitis) removed from the bone? It could have been, but the documentation really is not clear if it was or wasn't. Does this documentation support both codes? Mmmmm. It would be better if the documentation was more specific. By the way it's worded it's hard to say that both the osteomyelitis and fracture were both treated, but they probably were is my guess.
 
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