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Delayed union medial malleolus w bone graft?

  1. #1
    Location
    Columbus, Ohio
    Posts
    106
    Question Delayed union medial malleolus w bone graft?
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    Hello coders, I need your help again. How is an ankle repair with delayed union medial malleolus with bone graft coded? I can't seem to find anything close other than 27722 and I don't think I can use that;so I think I'm stuck using the 27899. If I use the unlisted code, how do I determine the fee? Thanks, Paula

    A small incision was made over the medial malleolus where the delayed union site was. Blunt and sharp dissection was taken down through the skin. Blunt dissection was taken down to this site. Fibrous tissue was curetted out with bone. The lateral bone of the medial malleolus
    appeared to be healing well. There was a small defect after curing of
    fibrous tissue. I did fill the defect with demineralized bone matrix
    and some crushed cancellus bone. This was packed in there very tightly.
    This was viewed under fluoroscopy and felt to fill the void very nicely.
    The periosteum was closed with 0-Vicryl The skin was approximated with
    2-0 Vicryl and then nylon was placed on the skin on the medial and
    lateral sides. Vita-Gel soft tissue autograft processed the patient's
    blood for postop hemostasis.Vita-gel was also injected deeply into
    the wounds. Local anesthetic was injected around the incisions.
    Sterile dressing was applied as well as a well-padded soft dressing.
    The patient was placed back in his walker boot.

  2. #2
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Quote Originally Posted by peporter View Post
    Hello coders, I need your help again. How is an ankle repair with delayed union medial malleolus with bone graft coded? I can't seem to find anything close other than 27722 and I don't think I can use that;so I think I'm stuck using the 27899. If I use the unlisted code, how do I determine the fee? Thanks, Paula

    A small incision was made over the medial malleolus where the delayed union site was. Blunt and sharp dissection was taken down through the skin. Blunt dissection was taken down to this site. Fibrous tissue was curetted out with bone. The lateral bone of the medial malleolus
    appeared to be healing well. There was a small defect after curing of
    fibrous tissue. I did fill the defect with demineralized bone matrix
    and some crushed cancellus bone. This was packed in there very tightly.
    This was viewed under fluoroscopy and felt to fill the void very nicely.
    The periosteum was closed with 0-Vicryl The skin was approximated with
    2-0 Vicryl and then nylon was placed on the skin on the medial and
    lateral sides. Vita-Gel soft tissue autograft processed the patient's
    blood for postop hemostasis.Vita-gel was also injected deeply into
    the wounds. Local anesthetic was injected around the incisions.
    Sterile dressing was applied as well as a well-padded soft dressing.
    The patient was placed back in his walker boot.

    Look at CPT code range 27720-27725 to see if one of these will work for you.

  3. #3
    Location
    Columbus, Ohio
    Posts
    106
    Default
    Thanks Mary, I had looked at the 27722 but wasn't quite sure about the bone graft part since it said sliding graft and I didn't know what that meant.

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