I have a question about coding a non-union takedown of the clavicle with ORIF.
Do I code 23515 for the ORIF and 23929 (unlisted) for the non-union takedown? The patient didn't have prior fixation done. Any help is greatly appreciated.
Report says:
PROCEDURE:
1. Open reduction, internal fixation left clavicle fracture.
2. Nonunion takedown.
OPERTIVE NOTE:
The fracture was then exposed. I used Hohmann
retractors as well as periosteal elevators to bluntly expose the fracture.
Next, nonunion takedown was performed utilizing various curettes, rongeur as
well as Joseph elevators to clean up the fracture site as well as all callus
around the fracture. Copious irrigation was then performed. I then used
pointed reduction clamps to reduce the fracture. I chose a 6-hole plate that
allowed for 3 screws fixation on either side of the fracture. The fracture
was then indirectly reduced and at this point I placed a medial screw, this
was a bicortical 3.5 screw. This allowed further reduction/indirect reduction
technique. I used plate clamps to hold the plate to bone. I then placed a
2nd screw on the opposite side more laterally of the fracture and I placed
this in compression mode. At this point multiple x-rays were taken which
showed adequate fracture reduction and hardware placement. I then placed
additional screws around the plate most medially based on the angle, I used
locking screws. At this point there was inferiorly on the lateral segment
there was a bony defect. I packed this area with 1 cubic centimeter DBM
putty. I copiously irrigated the wound. Final x-rays showed adequate
fracture reduction and hardware placement.
Do I code 23515 for the ORIF and 23929 (unlisted) for the non-union takedown? The patient didn't have prior fixation done. Any help is greatly appreciated.
Report says:
PROCEDURE:
1. Open reduction, internal fixation left clavicle fracture.
2. Nonunion takedown.
OPERTIVE NOTE:
The fracture was then exposed. I used Hohmann
retractors as well as periosteal elevators to bluntly expose the fracture.
Next, nonunion takedown was performed utilizing various curettes, rongeur as
well as Joseph elevators to clean up the fracture site as well as all callus
around the fracture. Copious irrigation was then performed. I then used
pointed reduction clamps to reduce the fracture. I chose a 6-hole plate that
allowed for 3 screws fixation on either side of the fracture. The fracture
was then indirectly reduced and at this point I placed a medial screw, this
was a bicortical 3.5 screw. This allowed further reduction/indirect reduction
technique. I used plate clamps to hold the plate to bone. I then placed a
2nd screw on the opposite side more laterally of the fracture and I placed
this in compression mode. At this point multiple x-rays were taken which
showed adequate fracture reduction and hardware placement. I then placed
additional screws around the plate most medially based on the angle, I used
locking screws. At this point there was inferiorly on the lateral segment
there was a bony defect. I packed this area with 1 cubic centimeter DBM
putty. I copiously irrigated the wound. Final x-rays showed adequate
fracture reduction and hardware placement.