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Orthopedic Coding Alert

Reader Question:

Removal of External Fixator Is Not Inclusive In ORIF

Question: Our surgeon did an external fixator removal and ORIF of distal tibia.The diagnosis recorded is as under:Left distal tibia and fibula fracture with compartment syndrome status post ORIF of the fibula, two incision, four compartment fasciotomies and subsequent closure and grafting status post external fixation of the tibia fracture.How do we report this?Colorado SubscriberAnswer: Confirm if this was a pilon or plafond fracture. If so, you report code 27827 (Open treatment of fracture of weight bearing articular surface/portion of distal tibia [e.g., pilon or tibial plafond], with internal fixation, when performed; of tibia only) with 824.8 (Unspecified fracture of ankle closed). For removal of external fixator, you report 20694 (Removal, under anesthesia, of external fixation system).

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