Wiki Revision open reduction, internal fixation of left ulnar with DBX graft

[Ksumansky]

I need some coding help please.

DX: Nonunion of left ulna status post open reduction, internal fixation.
Procedure performed: Revision open reduction, internal fixation of left ulnar with DBX (allograft) graft.

....The old plate was removed without difficulty. With small rongeur, curettes, and then a small drill, we cleaned out the fracture site back to waht appeared to be good bleeding bone. we put four holes on each side of the fracture and put in a 2.7 compression plate in. Intraoperative fluoro showed it appeared to be a good reduction. The was done by drilling, depth gauging, and placing the screws in. It should be noted that before we put the plate on, we did put DBX graft at the fracture site after it had been prepared. After we were finished with the plate, we used DBX graft to fill in a couple of screw holes that were visible with some DBX graft...................................................

I want to use 25999 because allograft was used, not autograft. and it was a nonunion. the other option could be 25545. Any thoughts would be wonderful.

Thanks!

 

[jdemar]

Look @ 25400 and the allograft is included unless the procedure was more difficult, refer to back to your physician for difficulty and if the 22 modifier is justified....the only allograft you can bill for is for SPINE SX.

If the nonunion was repaired with AUTOgraft then the code would be 25405.