Wiki malunion distal radius fx open reduction & percutaneous wire fixation with osteoclasi

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malunion distal radius fx open reduction & percutaneous wire fixation with osteoclasi

I have a question about Open reduction with osteoclasis and percutaneous wire(pinning) fixation of a malunion fracture of the distal radius. Dx 733.81

I have chosen 25400

Dr. wants 25606 and 25350.

Who is correct??? Anyone with documentation to support your answer(s)

 

[caromissunc1]

You are correct. The correct code is either 25400 or 25405.
Code 25606 is for acute fracture care, not a malunion. If you used it, you may be denied because the CPT code would not match the diagnosis. The acute fracture codes are used with an "8" code for ICD-9and a date of injury must be included on the claim. Usually malunions occur months after the original injury, therefore it would not be indicated in this circumstance.
As for 25350, that would also be incorrect. There is already an osteotomy present due to the malunion. In addition, an osteotomy is included these CPT codes. The code(s) 25400 or 25405 (depending upon whether or not he used an autograft), include the freshening of the existing ends of the radius for better callous formation.
My reference in this matter is the 2013 American Academy of Orthopaedic Surgeons Complete Global Service Data book, Volume 1 pages 574 & 575. It is a wonderful reference set (1 book is for integumentary and upper extremities codes, and volume 2 is for lower extremities and nervous system codes). It tells specifically what is and is not included for every CPT code used in orthopaedic procedures.
Hope this helps!