27786-27814: Be Confident in Your Ankle Fracture Repair Coding

Save your practice $100 with information of anatomic specifics.

Confused with bimalleolar and trimalleolar fracture codes? If this is the case, it could be costing your practice nearly $100 -- which is the difference in reimbursement between the open repair CPT codes for such ankle fractures.

Podiatrists must be definite while documenting fracture repair as CPT®'s index divides the ankle fracture codes into five kinds: lateral, medial, bimalleolar, trimalleolar, or posterior malleolus.

Type 1: Think if Lateral Malleolus Fracture Is Open Versus Closed

Even though CPT® leads you to the CPT codes 27786-27814 for lateral malleolus fractures, your work is not finished as podiatrists don't always show "lateral malleolus fractures" in their documentation. For example, your podiatrist may have documented "distal fibula" fracture as an alternative.

Next, you need to decide which surgical method the podiatrist carried out: closed or open.

Closed: For closed fracture treatment of the lateral malleolus, report either CPT code 27786 (Closed treatment of distal fibular fracture [lateral malleolus]; without manipulation) or 27788 ( . . . with manipulation).

Open: If the podiatrist performs open treatment, report CPT code 27792 (Open treatment of distal fibular fracture [lateral malleolus], includes internal fixation when performed).

Type 2: Ace Medial Malleolus Fracture Coding

Once more, for medial malleolar fractures, you require to define if the surgeon used a closed or open method.

Closed: In case the podiatrist carries out closed medial malleolar fracture treatment, you must report either CPT code 27760 (Closed treatment of medial malleolus fracture; without manipulation) or 27762 (... with manipulation, with or without skin or skeletal traction).

Open: You must report CPT code 27766 (Open treatment of medial malleolus fracture, includes internal fixation when performed) while the orthopedist uses an open method for the treatment of the fracture.

Type 3: Search for Bimalleolar Under Two CPT® Listings

You'll note that CPT® directs you to the 27808-27814 series in its index under both the "medial malleolus" and "lateral malleolus" listings. Each of this CPT code essentially represents bimalleolar fractures, which implies that the patient fractured the lateral as well as medial malleoli together.

Closed: You must report CPT code 27808 (Closed treatment of bimalleolar ankle fracture [e.g., lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli]; without manipulation) or 27810 (... with manipulation) in case the podiatrist carries out closed fracture care on a bimalleolar fracture.

Open: Once the podiatrist carries out an open surgical method for the treatment of a bimalleolar fracture, you must report CPT code 27814 (Open treatment of bimalleolar ankle fracture, [e.g., lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli], includes internal fixation, when performed) along with 824.4 (Fracture of ankle; bimalleolar, closed) or 824.5 (...bimalleolar, open) as the diagnosis.

Want to know about the trimalleolar, or posterior malleolus ankle fracture Medical Coding as well? Click here to read the whole article http://www.supercoder.com/articles/articles-alerts/pod/ankles-27786-27814-take-the-guesswork-out-of-coding-5-types-of-ankle-fracture-repair-codes-107795/

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