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Podiatry Coding & Billing Alert

CPT®:

Conquer 5 Types of Ankle Fracture Repair For Cleaner Claims

Published on Mon May 18, 2020

Hint: A bimalleolar ankle fracture involves two bones.

Fracture repair can be extremely difficult to code because there are so many details you must look for in the medical documentation to code correctly. For example, you must know if the podiatrist used open or closed treatment. You must also know if they used manipulation.

Take a look at five types of ankle fracture repair and learn how you can always submit clean claims in your podiatry practice.

Type 1: Observe Lateral Malleolus Fractures

One type of ankle fracture is a lateral malleolus fracture. When a patient has a lateral malleolus fracture, he has a fracture at the end of his fibula.

You should report the following codes for lateral malleolus fracture treatment:

For closed treatment, report either 27786 (Closed treatment of distal fibular fracture (lateral malleolus); without manipulation) or 27788 (... with manipulation). Report 27786 for an application of a cast, CAM walker, splint, or orthosis. Report 27788 when the fracture is displaced and the podiatrist needs to reduce it.

For open treatment, report 27792 (Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed).

Type 2: Know Bimalleolar Fractures Involve 2 Bones

A second type of an ankle fracture is a bimalleolar fracture. According to Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, senior director of coding education at Healthcare Information Services in Park Ridge, Illinois, “a bimalleolar ankle fracture will involve two bones: the medial, distal, end of the tibia — or medial malleolus; and the distal, outside, end of the fibula — or lateral malleolus.”

Additionally, a bimalleolar fracture can also be a break of the medial and posterior malleoli or the lateral and posterior malleoli.

You should report the following codes for bimalleolar fracture treatment:

  • For closed treatment, report 27808 (Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation) or 27810 (... with manipulation).
  • For open treatment, report 27814 (Open treatment of bimalleolar ankle fracture, (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed).

Type 3: Master Medial Malleolus Fracture Treatment

When a patient has a medial malleolus fracture, he fractures the inner side of his ankle at the end of the tibia. You should report the following codes for closed medial malleolus fracture treatment:

  • For closed treatment, report either 27760 (Closed treatment of medial malleolus fracture; without manipulation) or 27762 (... with manipulation, with or without skin or skeletal traction).
  • For open treatment, report 27766 (Open treatment of medial malleolus fracture, includes internal fixation, when performed), says Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan.

Coding example: The podiatrist needs to surgically visualize a medial malleolus fracture. Because this required exposure to the environment, you should report 27766.

Type 4: Identify Posterior Malleolus Fracture Repaid

When a patient has a posterior malleolus fracture, he has a fracture at the distal posterior aspect of the tibia. Report the following codes for posterior malleolus fracture treatment:

  • For closed treatment, report either 27767 (Closed treatment of posterior malleolus fracture; without manipulation) or 27768 (... with manipulation).
  • For open treatment, report 27769 (Open treatment of posterior malleolus fracture, includes internal fixation, when performed).

Coding example: The podiatrist performs open treatment of a posterior malleolus fracture, and he uses internal fixation. You should report 27769 for this procedure.

Type 5: Discover That Trimalleolar Fractures Involve 3 Bones

Similar to a bimalleolar fracture because it also involves the medial malleolus and lateral malleolus, a trimalleolar fracture additionally includes a posterior malleolus fracture. You should report the following codes for trimalleolar fracture care:

  • For closed treatment, report 27816 (Closed treatment of trimalleolar ankle fracture; without manipulation) or 27818 (... with manipulation).
  • For open treatment, use 27822 (Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip) or 27823 (... with fixation of posterior lip) for open trimalleolar treatments.

Don’t miss: When the posterior lip does not require fixation, report 27822. Otherwise, when the podiatrist needs to fix the tibial posterior lip, report 27823.

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