Podiatry Coding & Billing Alert

Question: According to the medical documentation, the patient has a Pilon/Plafond fracture of the weight bearing articular portion of his distal tibia. The podiatrist treated the fracture using closed treatment, without manipulation. The podiatrist administered anesthesia. Which CPT^® code should I report for this service?

Pennsylvania Subscriber

Answer: You should report 27824 (Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation).

With manipulation: On the other hand, if the podiatrist treated the Pilon/Plafond fracture with closed treatment and the fracture did require manipulation, then you would report 27825 (Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation). Note: An external fixator is often applied for stabilization of a pilon fracture after closed reduction when future open treatment is planned.

Pilon/Plafond fractures defined: Pilon fractures, also called Plafond fractures, are fractures of the distal part of the tibia, involving its articular surface at the ankle joint. Pilon fractures are caused by rotational or axial forces, usually a result of falls from a height or car accidents.

Pilon fractures are more complicated, comminuted fractures that have a poor long-term outcome, explains Jordan Meyers, DPM, partner at Raleigh Foot and Ankle Center and consultant at Treace Medical Concepts, Inc. in Raleigh, North Carolina.