Orthopedic Coding Alert

Question: A patient returned to surgery following unsuccessful closed reduction of a both-bone forearm fracture. The surgeon attempted intramedullary nailing; he was successful with the ulna but unsuccessful with the radius. He applied a plate to the radius and repaired a partial laceration of the EPL tendon that occurred during the attempted nailing. How should we code everything during the encounter?

South Carolina Subscriber

Answer: Report 25575 (Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna) for the surgery. You should not separately code the EPL (extensor pollicis longus) tendon repair for two reasons:

• The EPL repair is bundled with 25575.

• You cannot code for a complication that your orthopedist created during the surgery.