Orthopedic Coding Alert

Question: What is the correct coding for a mesoacromion repair? We have been using the unlisted code and comparing it to 23585.

Nebraska Subscriber

Answer: Experts suggest that 23585 (Open treatment of scapular fracture [body, glenoid or acromion] with or without internal fixation) is appropriate for this procedure.

Here's why: The mesoacromion is an anatomic term for one of the ossification centers of the acromion, which exist as separate segments until roughly age 20 when the three segments typically fuse. In some patients, the segments don't fuse, but the surgeon doesn't treat the mesoacromion unless it becomes symptomatic and painful, which effectively amounts to a mesoacromion stress fracture.

You may report the diagnosis with 811.01 (Fracture of scapula; closed; acromial process).

Tip: You also may see the terms "os acromiale" or "metacromion" used to describe this condition. There are some subtle differences, but your coding won't change because the different terms simply describe exactly where on the acromion the nonunion or stress fracture occurs.