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Percutaneous screw fixation of anterior column acetabular fracture.

Lynn Posted Tue 25th of August, 2015 13:14:18 PM

What is the best route to code the following? We have considered 27217 with mod 52 or using the Unlisted 27299 and comparing to 27216

PREOPERATIVE DIAGNOSIS: Right anterior column acetabular fracture.
POSTOPERATIVE DIAGNOSIS: Same.

PROCEDURE: Percutaneous screw fixation of right anterior column acetabular fracture.

HISTORY: 52-year-old male who fell a significant height at work and presented August 10th. We discussed treatment options, elected to proceed with the above. I think stabilizing this fracture is a good idea. Hopefully we can compress it some, but a great deal of displacement. He understands and wishes to proceed. Informed consent was obtained.

PROCEDURE: Patient underwent general anesthesia. The pelvis was sterilely prepped and draped in the usual fashion. A time out was performed verifying correct patient, procedure, and extremity. Antibiotics were given. Under fluoroscopy, I made an incision over the AIIS. I then used a 4.5 drill, drilled through the proximal fracture and used a 3.2 drill for a 4.5 compression screw. This had excellent purchase and it felt like this compressed very nicely and this is shooting to the greater sciatic notch, which was solid bone. I did not pass point to avoid injury to the sciatic nerve. I then then placed 2 AIIS to PSIS screws. The first being a 3.5 mm lag screw, the second being a static 3.5 mm screw. These also had excellent purchase. I then placed the anterior column screw under obturator oblique and inlet used to stabilize the anterior column as it crossed the superior pubic ramus. This had excellent purchase. Lateral fluoroscopic views of the acetabulum when we magnified showed excellent reduction. I think this stabilizes for any future displacement. We thoroughly irrigated and closed with small incisions, 2-0 Vicryl, and 3-0 nylon. Xeroform, sterile dressing was applied. He was awoken and taken to postop recovery in stable condition.

SuperCoder Answered Wed 26th of August, 2015 00:36:06 AM

AAE does not provide coding for operative reports and chart notes.
SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail customerservice@supercoder.com for more information.

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