Wiki Tibial Plafond Fracture

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Surgeon did ORIF of a tibial plafond fracture. He is including the fixation of the medial malleolus as part of CPT 27827.

The question is whether or not CPT 27784, ORIF of the fibula shaft, is separately billable.

:confused:
 
I suggest you review the next query regarding Tibial Plafond fractures. If both the tibia and fibula are fractured, which is usually the case in the severe cases, it really doesn't matter where the fibula is fractured (mid-shaft, lower shaft, or distally/lateral malleolus), the fixation of the fibula at any level would be included in the code 27828. So the answer to your question is no.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.
 
Dr. Alan Pechacek, MD ? What if the provider is doing a distal tibia plafond/pilon with syndesmosis distal tibiofibular? I run NCCI edits and it's denoted that 27829 bundles into 27828 as a more extensive procedure performed (only bill 27828). My providers are saying these are two different injuries and two separate incision. Still a tib/fib ORIF, provider sometime listen to other provider before their non-clinical coding staff. NCCI (Chapter 1, E) states they should be separate anatomical sites or separate encounters to justify the 59 modifier, this is all in the same setting. Appreciate any additional points of view. (27828 and 27829 are the only codes in question) Thank You!
 
AlanPechacek said:
I suggest you review the next query regarding Tibial Plafond fractures. If both the tibia and fibula are fractured, which is usually the case in the severe cases, it really doesn't matter where the fibula is fractured (mid-shaft, lower shaft, or distally/lateral malleolus), the fixation of the fibula at any level would be included in the code 27828. So the answer to your question is no.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.
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Dr. Pechacek I posted another question regarding this code. Please advise if you can. Thanks!
 
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