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Takedown Of Non Union ?

  1. Unhappy Takedown Of Non Union ?
    Medical Coding Books
    1. Take down of right clavicle nonunion.
    2. Open reduction, internal fixation, right clavicle fracture

    Codes I have are:
    23515 - ORIF Claivicle Fracture
    20680 - Removal of Hardware
    20902 - Bone Grafting

    Im just having troubel regarding the "takedown of the non union fracture". Is there a code Im missing or do I append a 22 modifier on 23515? Any help is greatly appriciated!

    Op Reort:

    The dissection was carried down to the level of prior open
    reduction and internal fixation. The plate was identified and
    successfully removed. The nonunion site was identified. Of
    note, the more medial aspect of the comminution of fracture had
    healed successfully. The nonunion site was then taken down.
    Bone graft was then used to fill this region. This was DBX
    putty. The fracture fragments were then reduced. The plate was
    then used to secure the fragment. Screws were then placed
    medially. These were utilized as same holes as before.
    Laterally, the fixation was extended by extending the incision
    laterally. Once this was complete, additional bone graft was
    used to incorporate the fracture site. Final fluoroscopy shots
    were taken and felt to be appropriate. The wound was then
    copiously irrigated with normal saline.

  2. #2
    Look at 23485. I think it covers the ORIF and graft codes. Hope this helps.

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