Orthopedic Coding Alert

Question: How can we bill for placement of an antibiotic nail for osteomyelitis of the tibia? The prophylactic code may not apply since the patient already has osteomyelitis. Please advise.

Maryland Subscriber

Answer: There is no code for an antibiotic nail in specific. You may report the usual placement of an intramedullary nail. We request you to share with us more information as to what exact procedure was done. Did your surgeon do a partial excision or cortical excision of the tibia? If so, you may appropriately report the specific services and report code 11981 (Insertion, non-biodegradable drug delivery implant) for the insertion of the antibiotic laden nail. You may also report 730 (Osteomyelitis periostitis and other infections involving bone, lower leg) as the ICD code.