Multiple fracture coding

2 scenarios...

ORIF for the Colles' fracture, but patient also has a nondisplaced ulnar styloid fracture (not reduced, FX was left alone). CPT 25608 and 25652 since he will be providing followup on both fractures OR can I only charge for 25608?

ORIF for Triplane tibial fracture, but patient also has a slightly displaced fibula (not reduced, FX was left alone). CPT 27827 and 27786 since he will be providing followup on both fractures OR can I only charge for 27827?

Is there any specific documentation needed in order to use both codes?

Thank you for your time!


  • edited May 2017
    you can only charge a fracture code if there is fracture code
    treatment....closed reduction, can use the dx of the non-treated
    fracture for any E/M codes ....but basically you are billing for what FX
    you treated and with global, you are basically not going to get paid for
    the other FX ...unless something comes up down the line you need to
    specifically must treat.


  • edited May 2017
    CPT states that when it comes to treating a distal radius fracture you can
    only report separately for the distal ulna (or styloid) if they do pinning
    or open treatment. That came out with the changes in 2007. You can't
    report 25652 unless you are treating the fracture open, which you stated you are
    CPT Assistant Oct 2007 had the following:
    "Fractures of the distal radius are often associated with ulnar styloid
    fractures. However, treatment of the radial fracture does not always include
    treatment of an ulnar styloid fracture. Therefore, parenthetical notes
    instruct the user that percutaneous (25651) and open (25652) ulnar styloid
    repairs should be reported separately. An exclusionary cross-reference also
    indicates that closed treatment of an ulnar styloid repair (25650) should not
    be reported in conjunction with codes 25600, 25605, and 25607-25609.
    Because reference to external fixation has also been removed from the new
    descriptor, if external fixation is performed in addition to the internal fixation
    described by code 25606, it should be reported separately with 20690,
    Application of a uniplane (pins or wires in one plane), unilateral, external
    fixation system.

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