Part B Insider (Multispecialty) Coding Alert

Elbow Aside Those Unlisted Codes For Tennis Elbow Surgery

Fracture care will gain some new codes in 2008. For example, new codes 27267-27268 cover -Closed treatment of femoral fracture, proximal end, head.- The first code is for treatment without manipulation; the second covers treatment with manipulation. A third code, 27269, covers open treatment of a proximal-end femoral fracture, including internal fixation, if any.

Three similar new codes (27767-27769) cover closed and open treatment of posterior malleolus fracture. You already have codes covering treatment of medial malleolus fracture (27760-27766), but now you-ll be able to code for posterior fractures as well.

Major change: Many other fracture care codes see changes in their descriptors. Previously, these codes included the phrase -with or without internal or external fixation.- Now, instead they contain: -includes internal fixation, when performed.- There's no longer any reference to external fixation. 

You-ll also have a new code (27416) for open osteochondral autograft of the knee (e.g., mosaicplasty) and one (28446) for -open osteochondral autograft, talus.- Both autograft codes include the harvesting of autografts.

Another new code covers the repair of a fibula non-union and/or mal-union, with internal fixation (27726).

Three new codes cover tenotomy of the lateral or medial elbow for epicondylitis, tennis elbow or golfer's elbow. These codes cover percutaneous tenotomy (24357), open tenotomy (24358), and open tenotomy with tendon repair or reattachment (24359).

Four new codes cover surgical arthroscopy of the subtalar joint. They break down into surgery with removal of loose body or foreign body (29904), with synovectomy (29905), with debridement (29906), and with subtalar arthrodesis (29907). Another new code (29828) covers arthroscopy of the shoulder, in the biceps tenodesis region.

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