Wiki 27829 with 27828

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pwebbabshire@cox.net

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Has anyone ever coded 27829 & 27828 together for the same ankle? No separate incisions were made. After the Pilon fracture was worked on a clamp was placed from the fibula to the tibia to gain reduction of the sydesmosis. Then two Sydesmosis screws were placed through the plate acheiving compression at the sydesmosis. These two codes bundle, but the extra work was performed. I am thinking about using the modifer xu. Any thoughts?
Thanks,
 
If two codes hit an edit, they have to qualify for an unbundling modifier. If the procedures were performed on the same ankle and through the same incision, how would justify both codes being supported? I know that syndesmosis disruptions frequently occur with pilon fractures. Common. In this situation I'm not sure that unbundling is correct. I would appreciate other input as well.
 
Hmm, good question. The NCCI edit they hit is more extensive procedure. If you read the definition in the NCCI manual, you can't report it separately for payers that follow NCCI.
L. More Extensive Procedure The “CPT Manual” often describes groups of similar codes differing in the complexity of the service. Unless services are performed at separate patient encounters or at separate anatomic sites, the less complex service is included in the more complex service and is not separately reportable.
 
pwebbabshire@cox.net said:
Update, I decided to not code the 27829.
Thanks for your help.
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I think that's a wise choice. Same ankle/incision I don't see how it could be considered not bundled. In ten years of coding these I have never seen a case where I thought that they were not bundled. With pylons the syndesmosis is frequently disrupted. I've even seen where the internal fixation for the pilon corrects the syndesmosis. Good job!
 
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