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Orthopedic Coding Alert

Reader Questions:

27506 Includes Nail Insertion

Question: Our surgeon performed an open reduction with internal fixation (ORIF) on a fracture of the right distal femur. The surgeon inserted an intramedullary retrograde nail as the fixation device. Which CPT code should we report for the ORIF and the nail insertion?

Tennessee Subscriber

Answer: You should report 27506 (Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws) for the surgeon's work performing the ORIF.
Because the descriptor reads "with or without external fixation," you should not report a separate code for the surgeon's work placing the nail.

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