While the information on this site is about health care issues and sports medicine, it is not medical advice. The code is valid for the year 2023 for the submission of HIPAA-covered transactions. M25.571 - Pain in right ankle and joints of right foot, M25.572 - Pain in left ankle and joints of left foot, M20.5X1 - Other deformities of toe(s) (acquired), right foot, M20.5X2 - Other deformities of toe(s) (acquired), left foot, M20.11 - Hallux valgus (acquired), right foot, M20.12 - Hallux valgus (acquired), left foot, M20.41 - Other hammer toe(s) (acquired), right foot, M20.42 - Other hammer toe(s) (acquired), left foot, Excision interdigital neuroma (Morton's neuroma) 28080, G57.61 - Lesion of plantar nerve, right lower limb, G57.62 - Lesion of plantar nerve, left lower limb, S93.324A - Dislocation of tarsometatarsal joint of right foot, initial encounter, S93.325A - Dislocation of tarsometatarsal joint of left foot, initial encounter, S82.52XA Displaced fracture of medial malleolus of left tibia, initial closed, S82.55XA Nondisplaced fracture of medial malleolus of left tibia, initial closed, M21.41: Flat foot [pes planus] (acquired), right foot, Q66.51: Congenital pes planus, right foot, M21.42: Flat foot [pes planus] (acquired), left foo, S82.871A - Displaced pilon fracture of right tibia, initial encounter for closed fracture, S82.874A - Nondisplaced pilon fracture of right tibia, initial encounter for closed fracture, S82.872A - Displaced pilon fracture of left tibia, initial encounter for closed fracture, S82.875A - Nondisplaced pilon fracture of left tibia, initial encounter for closed fracture, S93.431A - Sprain of tibiofibular ligament of right ankle, initial encounter, S93.432A - Sprain of tibiofibular ligament of left ankle, initial encounter, M25.571 pain in right ankle and joints of right foot, Z96.661 Presence of right artificial ankle joint, M25.572 pain in left ankle and joints of left foot, Z96.662 Presence of left artificial ankle joint, S86.011(ADS) Strain of Right Achilles tendon, S86.012(ADS) Strain of left Achilles tendon, M19.071 Primary Osteoarthritis, right ankle and foot, M19.072 Primary Osteoarthritis, left ankle and foot, S82.841A Displaced Bimalleolar fracture, right lower leg, initial closed, S82.851A Displaced Trimalleolar fracture, right lower leg, initial closed, S82.842A Displaced Bimalleolar fracture, left lower leg, initial closed, S82.852A Displaced Trimalleolar fracture, left lower leg, initial closed, S93.401(ADS) Sprain of unspecified ligament of right ankle, S93.402(ADS) Sprain of unspecified ligament of left ankle, S92.011A Displaced fracture of body of right calcaneus initial encounter for closed fracture, S92.012A Displaced fracture of body of left calcaneus initial encounter for closed fracture, S92.351A Displaced fracture of fifth metatarsal bone, right foot, initial closed, S92.354A Nondisplaced fracture of fifth metatarsal bone, right foot, initial closed, S92.352A Displaced fracture of fifth metatarsal bone, left foot, initial closed, S92.355A Nondisplaced fracture of fifth metatarsal bone, left foot, initial closed, S82.61XA Displaced fracture of lateral malleolus of right fibula, initial closed, S82.64XA Nondisplaced fracture of lateral Malleolus right fibula, initial closed, S82.62XA Displaced fracture of lateral malleouls of left fibula, initial closed, S82.65XA Nondisplaced fracture of lateral malleolus of left fibula, initial closed, Lisfranc ORIF/Arthrodesis Technique 28615, S82.51XA Displaced fracture of medial malleolus of right tibia, initial closed, S82.54XA Nondisplaced fracture of medial malleolus of right tibia, initial closed, Pilon Fracture Temporary External Fixation 20690, 1st Metatarsal Dorsiflexion Osteotomy 28306, Anterior Ankle Impingement Syndrome M19.079 715.17, Anterior Tarsal Tunnel Syndrome G57.50 355.5, Anterior Tibial Tendon Rupture S86.219A 727.68, Anterior Tibial Tendon Tenosynovitis M76.899 726.72, Calcaneous Fracture-Anterior Process S92.023A 825.0, Calcaneus Avulsion Fracture S92.009A 825.0, Dorsomedial Cutaneous Nerve Syndrome S94.30XA, Flexor Hallucis Longus Tendon Laceration S96.029A 892.2, Flexor Hallucis Longus Tenosynovitis M77.9 726.90, Lateral Malleolus Fracture S82.63XA 824.2, Lisfranc fracture-dislocation S93.326A 838.03, Lisfranc ORIF / Arthrodesis Technique 28615, Metatarsal Stress Fracture M84.376A 733.94, Metatarsalphalangeal Instability M24.876 718.87, Metatarsalphalangel Synovitis M12.279 719.27, Metatarsophalangeal Dislocation S93.129A 838.05, Modified Rotational Scarf Osteotomy for Hallux Valgus 28296, Navicular Stress Fracture M84.38XA 733.95, Peroneal Tendon Dislocation S86.399A 726.79, Posterior Ankle Impingement Syndrome M76.899 726.90, Posterior Tibial Tendon Dysfunction Insufficiency / Rupture / Dislocation M76.829 726.72, Talar Osteochondritis Dissecans M93.279 732.7, Talus Fracture - Lateral Process S92.199A 825.21, Talus Fracture - Posterior Process S92.109A 825.21, Tibialis Anterior Rupture S86.219A 845.00. Heres what she had to say. Open fractures are reported using the Gustilo-Grade Classification system (Types I, II, IIA, etc.). xmp.did:05d8e06f-c27c-4db7-ab06-766da5b197a4 Heres the 2 or 3 tips you need to master these fracture codes. Motor vehicle accidents, tripping or falling, contact sports, and twisting your ankle are some of the more common sources of injury that can lead to an ankle fracture. (such as a proximal and distal fracture site). If you continue to use this site we will assume that you are happy with it. The information on this website may not be complete or accurate. You might not need ORIF if you fracture your ankle. Considerations for the Post-operative Ankle ORIF Many different factors influence the post-operative ankle ORIF rehabilitation outcomes, including rate of healing, complexity of the fracture and/or need for hardware removal. direct approach to lateral and medial malleoli, reduction tenaculums to reduce fibular fracture, 2.0/2.7mm or 2.5/3.5mm lag screw perpendicular across fracture, neutralization plate direct lateral or antiglide plate posterolateral, pointed reduction tenaculums used for anatomic reduction, unicortical versus bicortical small fragment screw fixation, perform Cotton test / external rotation stress test to determine if syndesmosis injured, 1 or 2 screws, 3.5mm or 4.5mm, tricortical or quadricortical, 2-3 weeks non-weight bearing in AO splint, 4-6 wks in CAM boot with progression of weight bearing and range of motion exercises, ROM and weightbearing delayed ~2x if diabetic, identify ankle fracture pattern (Lauge-Hansen SA, SER, PA, PER) based on mechanism and pre/post-reduction xrays, systematically make list of damaged structures that need to be repaired, plan out relevant approaches to lateral and medial malleoli, c-arm from contralateral side, perpendicular to table, monitor at foot of bed, small fragment set (2.0/2.5/2.7/3.5mm drill bits, 2.7/3.5mm cortical screws, 4.0mm cancellous screws, 1/3 tubular plates), 4.0mm cannulated screws (guidewires, 2.5mm cannulated drill, 4.0mm cannulated partially threaded screws, washers), supine with feet at the end of the bed, bump under hip to get limb into neutral rotation (patella pointed towards ceiling), can elevate distal limb with bump or foam to minimize overlap from other ankle during lateral radiograph, mark out perpendicular line to fracture and place 2.7/3.5mm drill bit with sleeve on superior ridge of fibula in same perpendicular line, drill first cortex only with 2.7mm drill (for 2.7mm screw) or 3.5mm drill (for 3.5mm screw), insert 2.0mm sleeve into hole (2.7mm screw) or 2.5mm sleeve (3.5mm screw), drill far cortex with 2.0 bit (2.7mm screw) or 2.5mm bit (3.5mm screw), can countersink first cortex to increase surface area distribution for screw, keep depth gauge in drill hole to maintain orientation for screw placement, insert lag screw and hand tighten carefully to not break bone, watch for compression across fracture site, determine length of 1/3 tubular plate needed and check placement on C-arm, plan out 2 vs. 3 bicortical 3.5mm screws above and below fracture site, plan hole placement for possible syndesmotic screw placement, screw fixation will contour plate in non-osteopenic bone, contour distal aspect of plate if poor bone or very distal screw placement, contouring is done by by bending against screw driver tip or using handheld plate benders, distal fibula typically flares out laterally and then in more distally, drill bicortically with 2.5mm drill bit, then use depth gauge, insert appropriate length 3.5mm screw, alternating proximal to fracture then distal, most distal screw(s) are near joint, therefore drill unicortically and aim most distal screw in distal to proximal direction, 4.0mm cancellous screw used in this instance, alternatively, can drill and place a unicortical locking screw, clamp plate to bone proximally and drill/place non-locking screw in proximal hole in plate, drill and place another non-locking screw in the hole just proximal to the fracture line to obtain a reduction, distally, you can place a lag screw if desired, or place 1-2 screws to stabilize distal fragment, these screws can be bicortical as you are aiming anterior/lateral to the joint, leave distal hole empty if possible to minimize risks of peroneal tendon irritation, check with C-arm on mortise and lateral views, curved slightly anterior to visualize anterior edge of fracture line. 0000000856 00000 n
In some cases, your healthcare providers might do your ORIF a little later, so the swelling in your ankle can go down first. While the information on this site is about health care issues and sports medicine, it is not medical advice. APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Patients/participants: Subjects with bimalleolar equivalent ankle fractures were . Bi- means two; -malleolar pertains to the malleolus, the rounded, bony protuberance on each side of the ankle joint. Post-op: bulky jones dressing, NWB, elevation. Youll report these fracture fixes with the following codes: A trimalleolar fracture is a bimalleolar fracture with the addition of a fracture to the posterior portion of the tibia, for a total of three fractured bones. You must log in or register to reply here. A bimalleolar fracture occurs when both the medial malleolus and lateral malleolus are broken. If your bone is in pieces, it may need to be repositioned and held in place with screws or plates until . CPT codes should be selected based only upon choosing the code(s) that most accurately reflect the service(s) provided. These details will depend on where the injury is and how serious it is. identify ankle fracture pattern (Lauge-Hansen SA, SER, PA, PER). ORIF isn't for minor fractures that can be healed with a cast or splint. Shoulder360 The Comprehensive Shoulder Course 2023. 300-400 new vignettes are added each year as codes added, revised and reviewed. The description for 27814 Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation . apply pressure, then pronate hand to bring fibular out to length for right sided fractures, supinate for left sided fractures (SER patterns) mark out perpendicular line to fracture and place 2.7/3.5mm drill bit with sleeve on superior ridge of fibula in same perpendicular line. fracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs (Maisonneuve fracture) unstable: usually requires ORIF. You may have some pain after your procedure, but you may be prescribed pain medicines by your healthcare provider. Codes within the T section that include the external cause do . All Rights Reserved. Talk to your healthcare provider about how to get ready for the surgery. After determining the best answer, read the answer and rationale below. 27818 ( with manipulation) Tell your healthcare provider about all the medicines you take, including over-the-counter medicines like aspirin. Attention was then directed to the lateral aspect of the patient's left leg where . He has a previous bimalleolar fracture of this ankle after slipping and falling off a curb. Available for over 5000 of the most common CPT codes. Positioning. CPT code information is copyright by the AMA. Click Here. 0000008348 00000 n
2019-01-09T10:53:58.000-06:00 The defining characteristic of a trimalleolar ankle fracture is simple as well. Often, this means wearing a brace, perhaps for several weeks. One of the most important is whether the patient suffered a bimalleolar or trimalleolar ankle fracture. Site Terms | Copyright Information | ContactUs | Site Registration. Running, stair-climbing, and participation in sports are allowed only after a full range of motion of the ankle has been achieved. Adobe InDesign CC 14.0 (Macintosh) False Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. CPT Vignettes illustrate code use through sample patientexamples. Timing of surgery is dictated by the status of the soft tissues. OpenType - PS 2825763434 27823 - CPT Code in category: Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. different varieties and grades of severity of ankle fractures. The service [], Check for Underlying Cause on Pathological Dislocations, Question: What is the difference between pathological dislocations and recurrent dislocations? Lateral Malleolus Fracture ICD-9. 2825763434 You may need to have your stitches or staples removed a week or so after your surgery. One of the pins has apparently . Driving: may drive after 9 weeks for right leg. See Site Terms / Full Disclaimer. This section showsAPC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Your healthcare provider will make other repairs as necessary. 1.000 A pathologic fracture is caused by disease. 96331 3 Months: Begin sport specific rehab. When I started my education in medical coding, I had so many questions. mark out perpendicular line to fracture and place 2.7/3.5mm drill bit with sleeve on superior ridge of fibula in same perpendicular line drill first cortex only with 2.7mm drill (for 2.7mm screw) or 3.5mm drill (for 3.5mm screw) Also, let your healthcare provider know if there is increased redness, swelling, severe pain, or loss of feeling in your leg, or if you get a high fever or chills. According to the ICD-10-CM Official Guidelines for Coding and Reporting, a fracture not indicated as open or closed should be coded as closed. Are happy with it fracture your ankle ) Tell your healthcare provider falling off curb! Of this ankle after slipping and falling off a curb most common cpt should! Rate, Crosswalks, and more repositioned and held in place with or! 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