Results 1 to 7 of 7

Thread: Articular Fracture Proximal Phalanx

  1. #1

    Default Articular Fracture Proximal Phalanx

    I keep struggling with this one, so I'm hoping someone has so definetive information on how to code this.

    Doctor did a closed reduction of an articular fracture of the proximal phalanx and placed two percutaneous k-wires. I'm looking at 26742 but how do you get the k-wires? Are they billed as supplies? Would it be better to use an unlisted code? Help!!!

  2. #2
    Join Date
    Apr 2007
    Location
    Dane County - WI
    Posts
    31

    Smile

    Look at code 26727 - as it states "percutaneous pinning" this would be the K-wires.

    Per the Coders Desk Reference - " The physician treats a phalangeal shaft fracture of the proximal or middle phalanx, finger, or thumb with manipulation and secures it with a wire".

    Kate, CPC, COSC

  3. #3

    Default

    I agree with katiegal.

  4. #4

    Default

    This is an articular fracture which would place it at the proximal phalanx joint, so I don't think shaft fracture would apply.

  5. #5

    Default

    Maybe look at 26706 in CDR it says, the physician manipulates a metacarpophalangeal dislocation to restore anatomical position and secures the bone with a wire. The physician determines the dislocated position of the bone. The bone is relocated to correct anatomical position using external manipulation. The physician drills a wire into the metacarpophalangeal joint, through the fracture, and into the proximal bone. The drill entry point is dressed and the hand is splinted. And I got the definitions of dislocation fracture and articular fracture, and I think this one might work for you, by reading those. What do you think? I hope that helps. If not, then I guess it would be unlisted.

    dislocation fracture
    Type: Term

    Definitions:
    1. a fracture of a bone near an articulation with a concomitant dislocation of the adjacent joint.


    articular fracture
    Type: Term

    Definitions:
    1. a fracture involving the joint surface of a bone.

  6. #6

    Default

    Thanks for all your input on this one. I'm going with an unlisted code.

  7. #7
    Join Date
    Apr 2007
    Location
    Burlington, Vermont
    Posts
    14

    Default

    If the fracture/dislocation is at the metacarpalphalangeal joint (MTP), PIP or DIP, then 26742.

    Patrick

Similar Threads

  1. Lapidus w/proximal phalanx osteotomy
    By mellowyellow in forum Podiatry
    Replies: 1
    Last Post: 04-13-2015, 11:35 AM
  2. Resection head of proximal phalanx and middle phalanx
    By nsteinhauser in forum Podiatry
    Replies: 0
    Last Post: 06-21-2012, 08:35 AM
  3. Fracture of proximal phalanx
    By Claudia Yoakum-Watson in forum Orthopaedics
    Replies: 0
    Last Post: 08-04-2011, 08:45 AM
  4. Bone biopsy proximal phalanx toe
    By seslinger in forum Outpatient Facilities
    Replies: 8
    Last Post: 02-09-2009, 09:24 AM
  5. intra articular fracture vs extra articular fracture
    By acodingangel in forum Orthopaedics
    Replies: 2
    Last Post: 01-25-2008, 08:57 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •