Orthopedic Coding Alert

Question: May I bill debridement if the physician documents no gross contamination? The physician reduced an open tibia fracture, applied an external fixator, and performed irrigation and debridement. Minnesota Subscriber Answer: Your payer will most likely allow you to report the appropriate debridement code from the 11010-11012 series (Debridement including removal of foreign material associated with open fracture[s] and/or dislocation[s] -) as well as 27752 (Closed treatment of tibial shaft fracture [with or without fibular fracture]; with manipulation, with or without skeletal traction). Don't miss: You may also report a code such as 20690 (Application of a uniplane [pins or wires in one plane], unilateral, external fixation system) to reflect the surgeon's work applying the external fixation device to the patient's leg. Note: CPT 2008 removes 20690's modifier 51 (Multiple procedures) exempt status because the service is already subject to Medicare multiple-surgery payment reductions and requires significant pre- and post-service work. -- Reader Questions and You Be the Coder were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.