Cheryl Posted Thu 11th of June, 2020 13:30:02 PM
The doctor performed an repair of a nonunion tibia fracture, however, he used an intramedullary implant. Code 27759 best describes the work done but code 27720 is listed as the code to use for nonunion tibia repairs. The description on the Supercoder site for 27720 states "The provider holds the two ends of the fracture fragments together and secures them with plates and screws." This is not what my provider did as he repaired the tibia with an intramedullary implant. Would it be correct to code 27759?
SuperCoder Answered Fri 12th of June, 2020 05:39:26 AM
Hope you’re doing well!
Thank you for your question.
As per the above presented documentation, the doctor performed a repair of a nonunion tibial fracture. So, the intent of the visit was to repair a fracture of the tibia that has healed improperly or not at all.
In such case, you should report CPT® code 27720 (Repair of nonunion or malunion, tibia; without graft….)
CPT® code 27759 (Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage) applies to open treatment of tibial shaft fractures (acute or current) but not nonunion of old fractures.
Note: Open treatment of a tibial nonunion start with 27720 (without bone graft), 27722 (with sliding graft), and 27724 (with iliac or other autograft). However, intramedullary nailing is also a valid method of fixation/treatment of nonunion if it can be performed.
Hope that helps!