Wiki Arthroscopically Assisted ORIF vs. ORIF Bicondylar tibial plateau fracture

[mhink693]

We have a patient that the coding is being questioned whether this should've been billed as 27536 or as 29856. It's clear that the doctor used an arthroscope, but he also used the k-wires, which when looking at the description of 29856 it doesn't say anything about k-wires, it does talk about screws, but that's it. 27536 description does talk about k-wires, but obviously doesn't talk about the scope. So I was wondering if anybody had any thoughts on this and how it should be coded.
Thank you in advance!

 

[amyjph]

If the approach was arthroscopically assited (aided) and no open incision it's 29856.
The description is Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy). It states internal fixation which can mean plates, screws, wires, etc.
The description of the CPT doesn't specifically state what kind of internal fixation. Maybe you are reading a lay description or coding help tool?
Further, 27536 has an excludes note which excludes arthroscopic repair. So, if it was done via scope it's 29856. It comes down to approach.