Open tibia fx...can these cpt codes 20692,11012 and 27756 be billed together?

[Newilkinson13]

please help...provider irrigated and debrided the open tibia fracture with removal of skin, subq, muscle, fascia and bone...next provider applied external fixation (delta frame) to her open tibia shaft fx, because of patients fracture blistering and abnormal healthy appearance of her skin...to begin provider applied 2 schanz pins in the proximal tibia and also to the calcaneus and navicular...then applied the delta frame...should these codes be billed...20692,11012 and 27756? I checked encoder and it says that they can be billed together...

 

[Orthocoderpgu]

These three codes do not hit an edit. So all should be fine. So far I have never seen an external fixator (20692) hit an edit, but who knows?

I would question the code 27756 which is percutaneous fixation. If the physician is able to debride an open wound (11012) and remove hematoma and fractured bone, would the restorative procedure be percutaneous? Maybe it was but I would double read your note. Usually perc procedures are performed through small incisions that trocars are passed through to get to the site.

 

[Newilkinson13]

thank you...provider did extend the wound for the open fx to further I&D the tissue and bone...

 

[Newilkinson13]

thank you...this helps

...also the op note does state small stab wounds created for percutaneous pinning...

 

[Orthocoderpgu]

Well that makes sense. This seems to have been done backwards. Normally the debridement is performed first before the restorative procedure. Your codes should all be good then.