# Billing 27792 with 27829



## Mali0114 (Jan 21, 2016)

I have an Op report that states Fracture-dislocation Right ankle-  "the fracture was exposed by sharp dissection and reduced manually." Later it states a plate was then applied to the posterolateral edge of the fibula and fixed with 5 cortical screws. Then goes on to state that the anterior tibiofibular syndesmosis was fixed with a syndesmotic screw through the semitubular plate.
 Another staff member believes that we should bill for the 27792 in addition to the 27829.
 It seems to me that the CPT code 27829 includes the fracture reduction that was done. Of note is that only one incision was made.. Any insight is appreciated.
Thank you


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## amexnikki23 (May 9, 2016)

mali0114 said:


> i have an op report that states fracture-dislocation right ankle-  "the fracture was exposed by sharp dissection and reduced manually." later it states a plate was then applied to the posterolateral edge of the fibula and fixed with 5 cortical screws. Then goes on to state that the anterior tibiofibular syndesmosis was fixed with a syndesmotic screw through the semitubular plate.
> Another staff member believes that we should bill for the 27792 in addition to the 27829.
> It seems to me that the cpt code 27829 includes the fracture reduction that was done. Of note is that only one incision was made.. Any insight is appreciated.
> Thank you



was wondering if you have ever received any clarification on this?


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## shecodes (May 10, 2016)

CPT Assistant, March 2009 Page: 10 Category: Coding Consultation

Surgery/Musculoskeletal System  

Question: 
A patient was seen for a left ankle fracture dislocation with fractured lateral malleolus, disruption syndesmosis, and complete tear of the deltoid ligament. The physician performed an open reduction and internal fixation lateral malleolus, open repair of medial deltoid ligament, and repair of syndesmosis of the distal fibular tibial articulation. Is it appropriate to report CPT code 27829, Open treatment of distal tibiofibular joint (syndesmosis) disruption, including internal fixation, when performed, to describe this procedure?  

Answer: 
*It would be appropriate to report CPT code 27792, Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed, for the lateral malleolus fracture that includes the syndesmosis repair if a screw is put through the plate and into the tibia.* Report CPT code 27695, Repair, primary, disrupted ligament ankle; collateral, for the deltoid ligament repair. Code 27695 would be subject to modifier 51 in this circumstance. *CPT code 27829, Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed, is reported for the syndesmosis repair (subject to modifier 51) if a separate incision is made.*

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