# Revision  open reduction and internal fixation of the medial malleous



## maharajun (Jul 31, 2017)

Indication : Patient with ankle fracture  she underwent ORIF she returned 4 weeks and her hardware was noted to have failure with backing out of screws and gapping of fracture site 
Description of procedure : revision of ORIF of the medial malleolus

The overall fracture reduction was felt to somewhat difficult secondary to some additional bone growth secondary to the age of the fracture .This was removed sub periosteal fashion .The claw plate was placed .It was able to have appropriate reduction through the medial clear space. Once the overall reduction was felt to be acceptable , a compression screw was then placed across the fracture site  and additional screws were then placed 



could you please explain the CPT


Thank you have a great day


----------



## AlanPechacek (Aug 8, 2017)

In a sense, this is more of a "repeat" ORIF of the Medial Malleolus Fracture for loss/failure of fixation than a "revision."  This would be 27766: Open treatment of medial malleolus fracture with internal fixation.  As such, you would have to use Modifier 76: Repeat Procedure by Same Physician, assuming the same physician did both procedures, or Modifier 77 if done by different physicians.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com


----------

