Coding removal of fracture fragments

kssaba

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This is the first time I have come across a situation like this and I am hoping
someone can help me - I have a patient with displaced fracture fragments in the right index finger, middle phalanx. Fracture has been treated previously and there is some callous present at the fracture site. The physician made an incision beginning at the level of the proximal interphalangeal joint and extending over the middle phalanx. The flexor tendon was dissected and fracture fragments were removed.
A second incision was made of a nodular area over the proximal interphalangeal joint and a small piece of bone fragment was removed.

Would this be coded as foreign body removal??, open treatment of middle phalanx fx with 78 modifier?

Thanks to all for advice.
 

mbort

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I would look at the partial excision codes versus foreign body (check CCI edits with the ORIF code though) This seems to me to be more of an exostosis now. And yes to the 78 modifier if the patient is still in the global period.
 
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