Orthopedic Coding Alert

Question: What code would I use for a closed reduction of a distal tibial/fibular fracture? Can we report 27752?

Ohio Subscriber

Answer: According to CPT®, 27810 (Closed treatment of bimalleolar ankle fracture [eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli]; with manipulation) is used to report fractures of the distal fibula. Because the distal portion of the tibia/fibula involves the ankle and not the shaft portion of the lower leg, you report 27810 for a distal tibial/fibular fracture.

When you are confronted with a diagnosis of distal tibia fracture, always check with your surgeon to see if the fracture involves the weight bearing articular surface; if so, you would report code 27825 (Closed treatment of fracture of weight bearing articular portion of distal tibia [eg, pilon or tibial plafond], with or without anesthesia; with skeletal traction and/or requiring manipulation) instead of 27810.

CPT® code 27752 (Closed treatment of tibial shaft fracture [with or without fibular fracture]; with manipulation, with or without skeletal traction) involves the middle portion of the tibia and fibula, meaning NOT proximal or distal, but just the shaft.