Orthopedic Coding Alert

Question: A new patient presents to the office suffering from an injured left ankle she hurt while shoveling snow. The orthopedist performs a detailed history and examination. Suspecting a fracture, the orthopedist orders a twoview ankle x-ray, which reveals a bimalleolar fracture. The nonphysician practitioner (NPP) provides local anesthesia, and the surgeon uses closed treatment to manipulate the fracture. To ensure proper alignment, the orthopedist orders a second two-view ankle x-ray. Notes indicate moderate medical decision making. The orthopedist writes the appropriate prescriptions, the NPP casts the ankle and the patient goes home. Can I code both ankle x-rays in this scenario? Answer: Since the orthopedist orders separate x-rays for different purposes (identifying the fracture, ensuring proper bone placement), you can code for both. On the claim, report the following: 27810 (Closed treatment of bimalleolar ankle fracture [e.g., lateral and medial malleoli; or lateral and posterior malleoli or medial and [...]