ercoder65
Guest
I am at wits end trying to come up with a code that my Ortho doc finds acceptable. Here is what was documented:
1) left closed bimalleolar ankle fracture
2)left closed distal tibia/fibular ligament sprain
Procedures:
1)Open reduction internal fixation left bimalleolar ankle fracture, medial and lateral
2)closed reduction and internal fixation of left distal tibia fibular joint.
I have 27814 for #1, but #2 stumps me. His OP report states "Her syndesmosis was seen widened therefore a large pointed reduction clamp was used to clamp the tibia and reduce the syndesmosis. A 3.5mm syndesmotic screw of length 52mm was placed across the fibula into the tibia.".
I initially thought maybe this was a fracture, so I coded as 27756, but he said this wasn't fractured. I also can't use 27829, because he said it was a closed procedure.
He said it was a ligament injury, but when I read the report, I can't associate anything being done to the ligament.
Please help!!!!!
Rich
1) left closed bimalleolar ankle fracture
2)left closed distal tibia/fibular ligament sprain
Procedures:
1)Open reduction internal fixation left bimalleolar ankle fracture, medial and lateral
2)closed reduction and internal fixation of left distal tibia fibular joint.
I have 27814 for #1, but #2 stumps me. His OP report states "Her syndesmosis was seen widened therefore a large pointed reduction clamp was used to clamp the tibia and reduce the syndesmosis. A 3.5mm syndesmotic screw of length 52mm was placed across the fibula into the tibia.".
I initially thought maybe this was a fracture, so I coded as 27756, but he said this wasn't fractured. I also can't use 27829, because he said it was a closed procedure.
He said it was a ligament injury, but when I read the report, I can't associate anything being done to the ligament.
Please help!!!!!
Rich