Orthopedic Coding Alert

Question: Our physician performed an open reduction and pinning of a scapholunate dissociation with repair of the dorsal scapholunate ligament. We can't figure out which ICD-9 code to report. Is this a dislocation?

Texas Subscriber Answer: This condition is not a dislocation. Instead, scapholunate dissociation occurs when the scapholunate ligaments are torn and the bones spread apart.

You should report 842.01 (Strains and sprains of wrist, carpal [joint]) if the patient has an acute injury.

If the patient had a longstanding problem that caused the dissociation, you would instead report 718.83 (Other joint derangement, not elsewhere classified; forearm). In those more chronic cases, the physician may perform capsulorrhaphy, for which you should report 25320 (Capsulorrhaphy or reconstruction, wrist, open [e.g., capsulodesis, ligament repair, tendon transfer or graft] [includes synovectomy, capsulotomy and open reduction] for carpal instability)