Orthopedic Coding Alert

Question: How do you report the cannulated screw fixation of a triplane fracture?

Alaska Subscriber

Answer: A triplane fracture extends through the transverse (growth plate), sagittal (epiphysis), and coronal (distal tibial metaphysis) planes of the distal tibia. It disrupts the tibial plafond intra-articularly. You report code 27827 (Open treatment of fracture of weight bearing articular surface/portion of distal tibia [eg, pilon or tibial plafond], with internal fixation, when performed; of tibia only) for cannulated screw fixation of the triplane fracture.

You report 27827 when the fracture is directly visualized. If the screws are inserted percutaneously, you report the unlisted code 27899 (Unlisted procedure, leg or ankle), though it is rare to see this approach.