# Open reduction w/percutaneous pinning-distal phalanx articular fx



## RebeccaMoney (Nov 21, 2018)

I need help with the CPT for the above. Surgeon couldn't reduce the site under closed reduction so had to go to open. K-wires were placed through the fingertip down to the intramedullary canal of the distal phalanx and across the DIP joint. Physician gave me 26756 but I wander if I should go with open, 26765.
Thank you,


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## MI_CODER (Nov 21, 2018)

I would use 26765. The provider documents he was unable to perform a closed reduction with internal fixation therefore he converted to an open reduction with internal fixation.



> Open reduction of fracture with internal fixation is manipulative correction of a fracture to anatomical position after *incision into the fracture* site. Open reduction of a fracture involves *deliberate exposure* of the bone by the surgeon for the purpose of restoration of the proper anatomy.
> 
> Internal fixation is the stabilization of a fracture that is either undisplaced or has already undergone closed or open reduction. Closed reduction of fracture with internal fixation involves reducing the fracture without incision to the fracture site followed by incision for placement of the internal fixation device. *Internal fixation devices include* pins, *wires*, screws, plates, and intramedullary nails. Placement of internal fixation devices immobilize the fracture site; it is not a form of fracture reduction.
> 
> ...


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