Wiki Syndesmosis Repair with ORIF lateral malleolus


Burkburnett, TX
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Could someone please advise me on this? I have been billing the 27829 for the syndesmosis repair as well as the ORIF of whichever bone is fractured as long as the syndesmosis screws are not inserted through the plate used for the ORIF. Another coder has told me that that is incorrect and that the physician has to make a separate incision for the syndemosis repair in order to bill for it. Could someone else please advise and send thier reference material? Thank you!!!!!
Syndesmosis repair with ORIF

I thought so too but found a CPT Assistant March 2009 that states when an ORIF of the lateral malleolus is done and sydesmosis repair is done as well, that the syndesmosis repair can be charged IF a separate incision is made.
27792 vs 27829

Procedure :

An incision was made over the lateral fibula. Dissection was carried down to the fx, which was identified. A wright medicial unilateral EF was used, and the fibula was brought out to length and derotated. It was temporarily fixated with 0.062 inch K-wire, inspected under fulroscopy, and noted to be anatomically aligned. It was the fixated with 1 3.5 mm wright medical inter fragmentary screw. this was followed by a lateral contoured 3.5 mm WM locking plate & screw with excellent position noted on Inoperative fluroscopy. I externally rotated the foot against the fibula now that it was fixated & noticed gapping of the distal syndesmosis;therefore two 4.0 mm WM solid syndesmotic screws, fully theared screws, were placed across through the plate & into the medial cortex of the tibia.

Can we code both CPT 27792 & 27829 for this scenario?

Bharathi Tamilvanan
Tammey, things may have changed since 2012 when this thread first started, but as of today I can see nothing that would indicate that these codes can't be billed together looking at CMS and AAOS. CMS does not bundle the codes per their NCCI edits and AAOS in the GSD does not state anything about the codes being bundled either. I code a lot of foot and ankle surgery and have never had an issue with this.