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Thread: Cpt 27808

  1. #1
    Join Date
    Apr 2007

    Default Cpt 27808

    AAPC: Back to School
    Is this what you get out of this. CPT 27808

    DX- Bimalleolar fracture of the right foot.

    Op- Closed reduction and application of a long leg cast.

    Op Report: As follow. After the patient was positioned onto the operating table, a C-arm was moved in position for visualization of the ankle in th AP and lateral projection. By dorsiflexion of the foot, the fracture site came into anatomical psoition, and the ankle mortise was well maintained: and it was felt that because of the good position of the fracture it would not be necessary to do open procedure and plate the fibula. therefore, a long leg cast was applied to the foot in neutral psoition. postcasting x-ray demonstrated maintenance of the reduced position. The circulation remained good of the toes throughout the procedure. the patient then was allowed to awaken and left the op room in good condition.

    P.S- New to this, don't really get a bulk of these op reports, mostly code Family Physician services. But once in awhile I get these thrown on my desk. Any help will be highly appreciated.


    P.S- Can you code the casting with these services also.

  2. #2
    Join Date
    Apr 2007


    The casting or strapping code is reported in an instance when no other procedure or treatment (eg, surgical repair, reduction of a fracture or joint dislocation) is performed or is expected to be performed by the physician rendering the initial care only.

    Options for Guidelines

    The Application of Casts and Strapping guidelines allow a standard method of reporting casting and strapping for initial fracture treatment, initial immobilization of injuries other than fractures, and the reapplication of casts and strapping. The expanded use of these codes should help resolve many questions and address the inconsistencies previously experienced when reporting initial casting and strapping.

    The Application of Casts and Strapping guidelines now contain many options for the 29000-29799 series of codes. These codes may now be used to report:

    a replacement cast/strapping procedure, during or after the period of normal follow-up care;

    an initial service performed without restorative treatment or procedures to stabilize or protect a fracture, injury or dislocation, and/or to afford pain relief to a patient;

    an initial cast/strapping service when no other treatment or procedure is performed or expected to be performed by the same physician; or

    an initial cast/strapping service, when another physician provides a restorative treatment or procedure(s).

    Questions to Consider

    Before you report an initial cast/strapping with a casting and strapping code, consider the following questions:

    1.Will any restorative treatment or procedure(s) (eg, surgical repair, closed or open reduction of a fracture or joint dislocation) be performed or are they expected to be performed?

    2.Will the same physician assume all subsequent fracture, dislocation, or injury care?

    By answering these questions you will establish a good basis for deciding if the casts and strapping codes should be reported. Based on the answers to these questions, you can then refer to the general guidelines for specific rules when making a final code determination.

    hope this helps!
    Dr.Mohd Ali Hadi CPC, CPC-H
    Mohd Ali Hadi- CPC-H

  3. #3
    Join Date
    Apr 2007


    27808 is the correct code. With initial fracture care, you can not code the application of the cast per the previous entry.

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