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Lisfrance joint fracture dislocation ORIF 28485

Tanesha Posted Tue 03rd of December, 2019 23:30:48 PM
I have 28485 x2, but the doc refers to the lateral metatarsals. Op excerpt: Incision was accomplished over the medial cuneiform, it was visualized under x-ray, foot was relocated and stabilizing cuneiform lag screw was accomplished through a small fracture line through the medial cuneiform noted. After this was stabilized then under x-ray examination, guidewire was entered from the cuneiform to base of second metatarsal, the area had comminution and difficult integrity, but a lag screw was utilized to pull this into orientation. Next, the lateral metatarsals were extremely hypermobile and easily dislocating laterally, they were relocated and secured with 0.062 K-wires, there were good intraoperative x-rays with Lisfranc joint, and also the first metatarsal was stabilized with a percutaneous 0.045 screw.
SuperCoder Answered Wed 04th of December, 2019 03:39:26 AM
Hi Tanesha,
 
Thanks for your question.
 

Please note that Lisfranc Injury is a condition characterized by disruption between the articulation of medial cuneiform and base of the second metatarsal. So, code 28485 (Open treatment of metatarsal fracture, includes internal fixation, when performed, each) should not be reported since it is for repair of metatarsal fracture but there is no metatarsal fracture seen in the documentation. So, you may bill code 28615 (Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed) with 1 unit.

 

For repairing other metatarsals including second metatarsal, you may report code 28615 (Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed) with number of units depending upon the number of metatarsals treated.

 

Please feel free to write if you have any question.

 

Thanks.

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