Good Morning,

I need help with the following procedure. I am coding for ASC facility. Dr planned on an ORIF of tarsometatarsal joint but only did manipulation.

Mini C-arm fluoroscopy was used to visualize the left Lisfranc joint. There was found to be slight widening on this in comparison to the right foot. The left foot was stressed with a pronation adduction force. There was found to be no increased widening across the Lisfranc joint with stressing. This was visualized under live fluoroscopy and manipulated in various positions. Stress was placed across the first, second and third tarsometatarsal joints without dorsal or plantar subluxation. Based on the radiographic findings with stress views the decision was made to abort with open reduction and internal fixation.

Thanks, I appreciate your help.