adunlap23
Guru
Is a closed reduction with manipulation of a peri-lunate dislocation properly coded as 25660 since it is "peri"-lunate? or is 25690-closed treatment of lunate dislocation, with manipulation the correct code?
I thought the same thing, until I looked up pictures of a perilunate dislocation. It seems as though a perilunate dislocation is when the lunate is in place and the capitate (and sometimes other carpal bones) are out of place. I could be wrong.Good one. Did you check CPT Assistant to see if there is any guidance? I don't have access right now.
I would probably still use the 25690 since it specifically states lunate.
When I looked in Merck: " perilunate dislocation is disruption of the normal relationship between the lunate and capitate. A lunate dislocation is separation of the lunate from both the capitate and the radius."
Seems like for either one the lunate is disrupted so 25690 fits because it specifically says the word of the bone. Although the lunate and capitate are intercarpal. LoL! Conundrum.
True, hence "peri", so maybe it actually should be the other one, 25660? Since "around" the lunate is not actually the lunate itself? Times like this I would ask my hand/wrist doc what they thought and to describe the injury, if you have that ability.I thought the same thing, until I looked up pictures of a perilunate dislocation. It seems as though a perilunate dislocation is when the lunate is in place and the capitate (and sometimes other carpal bones) are out of place. I could be wrong.