# Metatarsal nonunion



## bethh05 (Mar 23, 2012)

OP Note reads:

Post op: Jones fracture, base of the fifth metatarsal, and nonunion x2 months, right foot. 

Procedure: ORIF, fifth metatarsal base with plate and screw fixation.

Description:
Attention was directed to the lateral aspect of the patient's right foot, where and incision was created along the shaft of the fifth metatarsal extending to the base of the fifth metatarsal. Significant fibrotic tissue was found interposed in a gapping fracture. The gap was at least 4mm on inspection and that same full 4 mm following preparation. The area was evacuated today with the use of a curette and bur to roughen the bone edges and remove all interposed fibrosis. The fracture site was noted to be reducible at this point and utilizing OA priciples, a 35-mm compression plate was inserted utilizing a 24-mm screw, 22-mm screw and 18-mm screw. Utilizing a mini C-arm ,the positioning of the metatarsal was noted to be appropriate and the fracture site was fully reduced. The area was flushed and closed. 

Would this be coded with 28485 or 28322? Does anyone know the guidelines for reporting nonunion codes?   Thank You


----------



## bethh05 (Mar 27, 2012)

Just an FYI, I done some research and found an article on the CMS website that states: 
"Effective September 15, 1980, nonunion of long bone fractures is considered to exist only after 6 or more months have elapsed without healing of the fracture."
 Long bones of the body include: Humerus, Radius, Ulna, Femur, Phalanges, Tibia, Fibula, Metacarpals and Metatarsals.


----------

