Wiki Percutaneous pinning medial malleolus - CPT?

[RebeccaMoney]

I believe I'm going to have to go with unlisted but wanted some other opinions. Operative report is attached. It does state that IM nailing but isn't an incision made to implant that? This op note looks to me like everything done was percutaneous pinning. I'm looking as unlisted for the fracture (not sure which is the comparison code, maybe 27756) and 27842 for the percutaneous pinning of the dislocation.
I appreciate any help. Thank you,

 

[nickelclaw]

Hello,
towards the end of report states there was a syndesmosis disruption which is aka the distal tibia/fibula dislocation S93.43- Cpt code for this or number 3 of Op note is 27829
below from the Coders Desk Reference of procedures by Optum 360:
27829

The physician makes an incision in the skin overlying the ankle. The tissues are dissected to the distal joint between the tibia and fibula. Nonviable tissues are debrided as needed. The physician places the tibia and fibula in the correct position to reduce or realign the disruption. Fixation devices, such as screws, are applied as needed to hold the joint (also known as a syndesmosis) in the correct position. The wound is irrigated and closed in layers. A cast or brace may be applied to the leg.

From nosology 3m "An open treatment is used when the fractured bone is either 1)surgically opened (exposed to the external environment and the fracture (bone ends) visualized and internal fixation may be used or 2)the fractured bone is opened remote from the fracture site in order to insert intramedullary nail across the fracture site (the fracture site is not opened and visualized)."

With this the code would be 27792 for the IM of distal fibula and 27829 for the disruption of syndesmosis(distal tibiofibular joint) and for treatment of the medial malleolus a small stab incision was made and pinned so code yes perq closed 27762

From nosology 3m "percutaneous skeletal fixation is fracture treatment which can apply to either open(compound) or closed fractures or joint injuries (dislocations). In this procedure the fracture fragments are not visualized, but fixation (eg., pins) is placed across the fracture site, usually performed under x-ray imaging.

Percutaneous pinning involves the placement of pins through the skin and into a fractured bone. Direct exposure of the fracture is not required. This type of pinning is most likely performed on non-displaced fractures or a closed reduction has already be