Answer ORIF with Intramedullary nail of supracondylar distal femur fracture with intercondylar extension

cliff.chen89

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Hello my fellow coders! Basically, I'm wondering for an ORIF and Intramedullary nail of supracondylar distal femur fracture with intercondylar extension, should I go with CPT 27513, 27506, or can I code both?

I can post the Op Report if anyone is interested. Basically, my doctor treated a supracondylar distal femur fracture with intercondylar extension by both ORIF (w/ plate, screws, and K-wires) and also an IM nail.

I'm trying to decide between either:
27513 - (Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed)
or
27506 - (Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws)

I'm veering more onto 27513 since the fracture was definitely supracondylar distal femur fracture with intercondylar extension, however the doctor clearly documents he put in a plate in th ORIF as well as an IM nail, which is why I'm wondering if I shoulder bill 27506 instead. Can I bill both of these codes? Which one would be the correct choice?
 
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Without reading the report I would go with 27513 based on the dx as the IM nail could be part of the internal fixation
 
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