# Tibial plafond fx



## Beckiep1 (Mar 9, 2011)

Dr. performed an ORIF of the distal tibial pilon fx.  During the procedure he also repaired the medial malleolus and medial aspect of the tibia were fixed.

Same incision.

Is this all included with 27827?

Thank you!!

Beckie


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## daedolos (Jan 31, 2018)

Did you ever resolve this CPT issue?

Peace
?_?


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## AlanPechacek (Jan 31, 2018)

The direct answer to your question is *yes*, fixation of the medial malleolus is included in the code *27827*.  *Tibial plafond fractures* are usually rather severe fractures of the distal tibia which affect the weight bearing area of the tibia into the ankle joint, and a part/element of this fracture is/includes the medial malleolus, which may be a fragment of variable size.  Depending on its size and displacement/instability, it may require specific surgical attention to fixate it in place, in addition to the rest of the fracture fragments over the top of the ankle joint.
     As for* 27826*, the tibia and fibula are both fractured, but only the fibula is surgically fixated, which seems a bit bizarre, but the tibial fracture may be so severe that there is no good way of repairing/fixating it surgically, and often/usually an External Fixator is placed on the tibia to distract and align the tibial portion, and the fibula is fixated to help align and further stabilize the ankle region.
     If both are operated upon and fixated, then *27828* applies.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.


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