# Widening of syndesmosis



## Alta (Jan 28, 2009)

The pt had a fx 6 months ago which healed, but he was supposed to keep a boot on and didn't, so he now has widening/displacement of the syndesmosis.  He came in to the OR for closed percutaneous pinning with 2 screws.  She used a clamp to reduce widening, then placed two screws percutaneously.  The encoder leads me to an unlisted code.  I am wondering if I can use 27842.  Would you use it?  Is the widening/displacement considered a dislocation of sorts?  Thanks!


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## dianne (Jan 28, 2009)

code 27829 would be more appropriate if procedure was open, but I think I would use the unlisted code. for dx I would use 845.03 for syndesmotic disruption. Anyone else have any thoughts?


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## mbort (Jan 28, 2009)

dianne said:


> code 27829 would be more appropriate if procedure was open, but I think I would use the unlisted code. for dx I would use 845.03 for syndesmotic disruption. Anyone else have any thoughts?



I agree with Dianne, the 27829 would be the more appropriate code had this case been done with open technique.  Since it wasnt then you are stuck with an unlisted and you can reference this code.  (I dont think I would use 845.03 though, that is for a sprain of the tibiofibular ligament, I would lean towards the dislocation code 837.0)
Mary, CPC, COSC


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## Alta (Jan 28, 2009)

*Thank you both for taking the time to answer, so*

if 837.0 Closed dislocation of ankle is good for ICD-9, then for the CPT what about:

27842 Closed treatment of ankle dislocation, requiring anesthesia, with our without percutaneous skeletal fixation.  ?

I haven't had much experience with unlisted codes, I need to read up on it.  

Thanks again


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## mbort (Jan 28, 2009)

Jamshidi said:


> if 837.0 Closed dislocation of ankle is good for ICD-9, then for the CPT what about:
> 
> 27842 Closed treatment of ankle dislocation, requiring anesthesia, with our without percutaneous skeletal fixation.  ?
> 
> ...



27842 could work depending on the documentation


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