Orthopedic Coding Alert

Question: Our orthopedist completed several procedures during the same operative session: open reduction, internal fixation, and external fixator application to a tibial plateau fracture; allograft application; and external fixator application to the tibial plafond fracture. What codes should we submit?

California Subscriber

Answer: Some of the procedures your surgeon completed fall under the same codes, so streamline your claim to two codes. List 27535 (Open treatment of tibial fracture, proximal [plateau]; unicondylar, includes internal fixation, when performed) first for the open reduction and fixation. Then list 20692 (Application of a multiplane [pins or wires in more than 1 plane], unilateral, external fixation system [e.g., Ilizarov, Monticelli type]) for the external fixator stabilizing the tibial plafond fracture.

Remember: Coding guidelines don't provide a way for you to separately report the allograft. Although your surgeon completed the allograft during the surgery, you won't report a separate code.