AAPC - Back to school
Results 1 to 3 of 3

Thread: new coder needs help

  1. #1

    Default new coder needs help

    AAPC: Back to School
    I have a case where there is a left ankle trimalleolar fracture and left ankle syndemosis. The doc does ORIF left ankle , 27822 and a ORIF left ankle syndesmosis, 27829. I am wanting to know if the syndesmosis is bundled in with the 27822.

    My dictation reads: Incision was fashioned over the laterial aspect of the fibula taking care to protect surrounding neurovascular structures in particular the superficial peroneal nerve. The fracture ws identified over the distal one third of the fibula. It was held in position with a bone clamp. Some small amount of periosteum was removed from the edge of the fibula around the edge of the fracture. An interfragmentary screw was then drilled, measured and appropriate screw length applied across the fracture. An eight hole one-third semitubular plate was then prebent and contoured to the distal fibula. A nonlocking screw was drilled and placed proximal and distal to the fracture. Additional screw holes were filled with locking screws leaving two screw holes open around the fracture site and along the area of the interfragmentary screw. One screw hole was left in the second most distal screw hole to place the syndesmosis screw. Attention was next turned to the medial malleolus. An anteromedial incision was fashioned over the medial malleolus. Care was taken to protect the saphenous vein and nerve. The fracture was reduced and held with a bone holding clamp. It was subsequently then pinned with two guidepins for the 4.0 mm cannulated screws. Image intensification confirmed good position of the guidewires on AP, lateral and cannulated screws with washers were placed. The guide pins were removed. Image intensification confirmed good position of the medial malleolar screws. Attention was next turned back to the scyndesmosis screw. With the ankle held in neutral to dorsiflexion the second to distal most screw hole was left open, and the plat was subsequently drilled with the 2.5 mm drill bit aiming slightly anterior for the fibular to the bibia. This was measured and a 50 mm 3.5 mm fully threaded cortical screw was placed. Care was taken to provide manual pressure over the medial aspect of the ankle to avoid any gap at the medial mortise.

  2. #2
    Join Date
    Apr 2007
    Piedmont Area Coders, VA


    It passes CCI edit check. Based on the documentation, I think I would bill both. Make sure you use the syndesmosis disruption ICD-9 for the 27829, and the Trimal Fx ICD-9 for the 27822.
    Good Luck!

  3. #3


    Thank you for your help.

Similar Threads

  1. OP Hospital Facilty coder & ED coder needed
    By anelson30 in forum Resume Postings
    Replies: 0
    Last Post: 07-30-2015, 12:47 PM
  2. Outpatient Coder Interviewing for Inpatient Coder Position
    By ealasaid76 in forum Employment General Discussion
    Replies: 0
    Last Post: 01-22-2014, 07:03 AM
  3. Replies: 0
    Last Post: 10-06-2013, 01:53 AM
  4. Newly certified coder looking for work/internship as apprentice coder
    By laceysterror@hotmail.com in forum Resume Postings
    Replies: 0
    Last Post: 12-13-2011, 03:10 PM

Posting Permissions

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

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.