Orthopedic Coding Alert

Plus: Mosaicplasty gains a code, modifier descriptors are overhauled CPT 2008 is the orthopedic coder's friend this year, with dozens of new codes to make your fracture care and surgical coding a lot easier. "I am excited about the number of additions to the orthopedic codes for next year," says Shelly Ghrist, CPC, coder at Wolf Creek Medical Associates in Grove City, Pa. "I-m also glad that there aren't a lot of deletions." Indeed, CPT didn't include many code deletions for orthopedic surgeons, which means you-ll have more codes than ever before to choose from when you-re reviewing your coding choices. CPT Overhauls Fracture Care Codes Several coders we spoke to were delighted to see the following new femur fracture codes: - 27267 -- Closed treatment of femoral fracture, proximal end, head; without manipulation - 27268 -- ... with manipulation - 27269 -- Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed. "The femoral fracture code additions are good news for orthopedic coders," says Heather Corcoran, coding manager at CGH Billing in Louisville, Ky. "Coders have been looking for a way to code treatment to the proximal end of the femoral head." Ankle fractures: You already have codes covering treatment of medial malleolus (27760-27766) and lateral malleolus (27786-27792) fractures, and now you-ll be able to code for posterior fractures as well, with these three new codes: - 27767 -- Closed treatment of posterior malleolus fracture; without manipulation - 27768 -- ... with manipulation - 27769 -- Open treatment of posterior malleolus fracture, includes internal fixation, when performed. Expect Better Accuracy This series should improve coding accuracy for orthopedic offices, particularly those with foot and ankle specialists on board. "I was just looking the other day for a code for a posterior malleolus fracture," Ghrist says. Big change: You-ll note that CPT has revised the descriptors of more than 50 fracture care codes. In the past, most of these codes included the phrase "with or without internal or external fixation." Now, instead they contain the phrase "includes internal fixation, when performed." This change will make it easier to separately code external fixation if the physician performs it, says Leslie Follebout, CPC-ORTHO, coding department supervisor at Peninsula Orthopaedic Associates in Salisbury, Md. Get to Know Knee, Spine Codes CPT also brings positivity with the addition of 27416 (Osteochondral autograft[s], knee, open [e.g., mosaicplasty] [includes harvesting of autograft[s]). "I love the much-needed mosaicplasty code," Follebout says. "One of my surgeons does that procedure all the time." You-ll also benefit from new code 28446 (Open osteochondral autograft, talus [includes obtaining graft[s]), which describes "open osteochondral autograft, talus." Another new code covers the repair of a fibula non-union and/or malunion with [...]