Orthopedic Coding Alert

Question: Our doctor needed to treat osteomyelitis while the patient had an active fracture. The Patient has a post operative infection.  The patient needed to be treated with an antibiotic nail within the 90 day global to treat the infection and also secure the fracture of the tibia. Should we bill this as 27759 (Treatment of tibial shaft fracture [with or without fibular fracture] by intramedullary implant, with or without interlocking screws and/or cerclage) or 27640 (Partial excision [craterization, saucerization, or diaphysectomy], bone [eg, osteomyelitis]; tibia)?

New Mexico Subscriber

Answer: You report 27759 for the tibial fracture repair. In addition, you 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.