1. Wanda Jensen
   Posted 1 year ago #
   

   Does anyone know if 25680 would be the right code for a closed reduction and percutaneous pinning of a perilunate dislocation? There is no code for percutaneous pinning of that area. Help...
   Thanks WJ

2. SuperCoder
   Posted 1 year ago #
   

   25680 is correct

3. Wanda Jensen
   Posted 1 year ago #
   

   Thanks I was going back and forth reading material from the internet and noticed that they had called this a de Quevain's but is that only for a fracture? Since this is a dislocation is my understanding that it would not be a de Quervain's?
   I reread the op note and 25660 might also apply because he pinned several other bones as well as the lunate. And my other question, in using the 25680 or 25660, would I use a 22 modifier to show the extra percutaneious pinning? He pinned several bones percutaneously that I can't find specific codes for as follows:

   Distal traction and pressure was able to reduce the perilunate dislocation.
   Two 0.45 K-wires were then driven through the dorsum into the scaphoid
   and the lunate as joysticks to correct the dorsal displacement of the
   lunate. A K-wire was then placed through the distal radius to take
   the lunate out of a dorsal tilt. Traction was then placed on the arm
   and 0.45 K-wires were driven from the scaphoid to the capitate and
   from the scaphoid to the lunate. Two pins driven from the scaphoid to
   the lunate and then the lunate triquetral articulation was also
   pinned. This appeared to provide satisfactory stability and alignment
   of the carpal bones. The joystick pins were removed and the pins cut
   outside the skin. Sterile dressing was applied. X-ray was obtained.

   Please let me know if all of this would be enough for the 22 modifier or if 25660 would be more in line since it was more than the lunate bone. The more I read the more confused i am. Thanks Wjensen

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