Please HELP! closed vs open reduction vs percutatneous....Margie/Ruby?

I'm a bit confused on this one. Can someone please help?
Is this closed reduction, open reduction or percutaneous?

The procedure performed heading indicates closed reduction and screw fixation of lateral malleolus fracture. Doc indicates it is a closed reduction with percutaneous fixation. Just double checking based on the description of the procedure. Since two small incisions were made to rotate the fragment, is this an open or closed reduction?

...... Under fluoroscopic guidance we made two small incisions to place our abduction forceps. With the reduction forceps in hand we were able to rotate the fragment into position and keep it reduced manually. We then made a small incision distally. We placed a K-wire from distal to proximal, overdrilled the near cortex and then placed a 70 mm 4.0 screw and we were able to obtain good purchase proximally. Once that was done and fixed, we irrigated the wound with copious amounts of normal saline, closed the wound with 4-0 Monocryl suture. We placed Dermabond over the smaller incisions and then injected the areas with plain Marcaine roughly 20 mL total. We placed Betadine ointment and sterile dressing and Ace bandage. The patient was then placed into a Cam boot. She was then awakened from anesthesia and returned to the PACU in stable condition.

Comments

  • Verbally, he is indicating it was a closed reduction with percutaneous pinning but what I am a little confused about is that
    he is saying he made, "two small incisions to place our abduction forceps. With the reduction forceps in hand we were able to rotate the fragment into position and keep it reduced manually".

    Do the incisions have to be a certain size to consider this open or what is the rule for this?...and if I am coding closed reduction (27788) then what code do I use for the percutaneous pinning for the placement of the K wire and screw (do I use 27899).
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