lorrib
Contributor
Hi,
I am hoping someone can help me with an Open Reduction and Internal Fixation, for a periprosthetic femur fracture. Here is the Op note:
Diagnosis: Periprosthetic right femur fracture (patient has a right total hip arthroplasty)
Procedure: Open reduction and internal fixation, right periprosthetic femur fracture at the hip.
The patient was brought to the operating room. Her Old incision which was lateral was utilized. The incision was carried through skin, subcutaneous tissue, through the fascia lata. The gluteus medius was left intact. Predominantly the incision was made in the vastus lateralis and extending it up to the level of the greater trocahanter and just proximal and then reflecting the tissue anteriorly and posteriorly to visualize the fracture. She had a large medial spike to her femur. She had fairly brisk bone bleeding and reducing her medial spike with a Lowman clamp controlled her blood loss. The fracture was readily reducible. Two bone cortical graft pieces were utilized and three 2.0 cables were placed, the most proximal one was____, the two distal ones were stainless and cerclage wires were placed carefully around securing the two bone struts. They were tightened, the more lateral of the 2 struts did crack during tightening. The reduction visualized appeared quite good. Some cancellous bone from encountering of the struts was available and that was used for grafting as well. The wound was copiously irrigated. Hemostasis is controlled throughout the case with electrocautery. Her fascia was closed with a nonabsorbable braided suture in layers. Subcutaneous closed with Vicryl and Stratafix. Skin was cloased with staples.
I am thinking the cpt code should be 27244 but I don't see where a plate was utilized for the internal fixation and the physician appears to have used bone grafting?
Any assistance provided would be greatly appreciated.
Thank you,
Lorri
I am hoping someone can help me with an Open Reduction and Internal Fixation, for a periprosthetic femur fracture. Here is the Op note:
Diagnosis: Periprosthetic right femur fracture (patient has a right total hip arthroplasty)
Procedure: Open reduction and internal fixation, right periprosthetic femur fracture at the hip.
The patient was brought to the operating room. Her Old incision which was lateral was utilized. The incision was carried through skin, subcutaneous tissue, through the fascia lata. The gluteus medius was left intact. Predominantly the incision was made in the vastus lateralis and extending it up to the level of the greater trocahanter and just proximal and then reflecting the tissue anteriorly and posteriorly to visualize the fracture. She had a large medial spike to her femur. She had fairly brisk bone bleeding and reducing her medial spike with a Lowman clamp controlled her blood loss. The fracture was readily reducible. Two bone cortical graft pieces were utilized and three 2.0 cables were placed, the most proximal one was____, the two distal ones were stainless and cerclage wires were placed carefully around securing the two bone struts. They were tightened, the more lateral of the 2 struts did crack during tightening. The reduction visualized appeared quite good. Some cancellous bone from encountering of the struts was available and that was used for grafting as well. The wound was copiously irrigated. Hemostasis is controlled throughout the case with electrocautery. Her fascia was closed with a nonabsorbable braided suture in layers. Subcutaneous closed with Vicryl and Stratafix. Skin was cloased with staples.
I am thinking the cpt code should be 27244 but I don't see where a plate was utilized for the internal fixation and the physician appears to have used bone grafting?
Any assistance provided would be greatly appreciated.
Thank you,
Lorri