Orthopedic Coding Alert

Question: Which CPT and ICD-9 codes should we report when the surgeon dictates a Weber B fracture repair?


Oklahoma Subscriber


Answer: Orthopedic surgeons often use terms in their dictation that don't appear in CPT, and -Weber B- is one of those. When a surgeon addresses a Weber B fracture, he is treating a fracture in the distal fibula, which is coded as a lateral malleolar fracture (824.2-824.3).

The Weber classification always refers to a distal fibular, or lateral malleolar, fracture. Type A describes the distal fibular fracture below the ankle syndesmosis. Type B has the distal fibular fracture intersecting the syndesmosis, and Type C involves the distal fibular fracture above the syndesmosis. Patients may have a concomitant medial malleolar fracture, which, if treated, would be coded as a bimalleolar ankle fracture.

Depending on whether the surgeon performed an open or closed repair, you should select a code from the following range for a Weber B fracture:

- 27786--Closed treatment of distal fibular fracture (lateral malleolus); without manipulation
- 27788--... with manipulation
- 27792--Open treatment of distal fibular fracture (lateral malleolus), with or without internal or external fixation.