AHA Coding Clinic® for ICD-9 - 2012 Issue 2; Ask the Editor

Arthroscopic Assisted Fracture Reduction

Orthopedic surgeons at our hospital are now performing arthroscopic-assisted fracture reduction.  In this case, the patient had an arthroscopic-assisted open reduction with internal fixation (ORIF) of a right tibial plateau fracture. At surgery, the arthroscopy portal was placed and the entire knee was examined. The arthroscopy equipment was then removed and an incision was made lateral to the tibial crest. The drill was used to open up a small cortical window, a bone tamp was inserted and advanced using fluoroscopic guidance. The impacted medial articular fragment was elevated. Once adequate elevation of the fracture was achieved, the scope was placed back inside the knee and the entire site evaluated. An incision was made over the medial aspect of the knee and fixation screws were placed. The knee was copiously irrigated and re-examined via arthroscopy and fluoroscopy. The wounds were then closed, dressings applied, immobilization placed, and the patient was taken to the recovery room. For coding purposes, is this considered “closed” reduction or “open” reduction and what is the appropriate procedure code assignment?  ...

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