# ORIF Subtroch/ Intertrochanteric hip fracture



## ortho1991 (Oct 20, 2008)

I hope someone can give me some advise on this.  

Our surgeon writes subtroch/intertrochanteric hip fracture.   

Note reads her left leg was placed in the lithotomy left holder and her fracture was then reduced under fluoroscopy.  Once this was in place, she was prepped and draped in the usual sterile fashion. A laterla incision was made through the IT band through the vastus lateralis and down to the lateral femur. The lateral femur was essentially comminuted approximately from the greater trochanteric region all the way up across, and you could see the lesser troch was actully fractured off as well, fractured at the lesser troch. At first I tried to place the guide for a 95 degree DHS but because of the comminution and because of the piece, I felt that it best to go with the 135 and try to carry the fragments proximally. I than placed a 135 and was able to get a good purchase of the head, both on the AP and lateral and then measured to about a 75 and placed a 70mm super lag screw with excellent fixation into the proximal femur.  Once this was completed. I then impacted a 4-hole, 135 degree plate.  We then took the traction off and we subsequently compressed the fracture fragment.  All four holes were then filled with 45 fully threaded cortical screws in the standard AO technique.

Can we bill for both closed treatment of the subtroch 27240 and ORIF 27244 Intertrochanteric fracture.

Thank you,
Any thought and help will be greatly appreciated.


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## mbort (Oct 20, 2008)

only the ORIF


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## ortho1991 (Oct 21, 2008)

Thank you for your help.


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