10/26/2017

Correct Billing for a Charcot Lisfranc Dislocation

How do I bill a Charcot Lisfrancs dislocation of mets 1,2,3,4 and 5 with ORIF, beaming, exfix etc.....

CPT code 28615 would be reported for the fixation of the dislocation with modifier LT. CPT code 28485-59, LT would be reported five times to represent each metatarsal fracture, per CPT description of the code.

28615 LT

28485 59 LT

28485 59 LT

28485 59 LT

28485 59 LT

28485 59 LT

28615

The physician performs open treatment of a tarsometatarsal joint dislocation. A dorsal incision is made over the dislocated bones. The soft tissues are reflected to expose the joint. The joint is properly aligned and stabilized with screws, plates, or wire fixation. The incision is closed with sutures and a cast is applied. Weight bearing is allowed at six weeks. At that time the physician may remove the metal fixation.

In addition, Internal fixation, when performed, is included in this procedure. External fixation, if performed, is reported separately. According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. 

28485

The physician treats a fracture of one of the five metatarsals with open surgery. An incision is made overlying the particular metatarsal fracture. The tissues are dissected and debrided as needed. The fracture is identified and exposed. Any tissue between the fracture pieces is removed. The fracture fragments are reduced (realigned) to their correct position. Fixation devices are applied as needed to hold the fracture in place. The wound is irrigated and closed in layers.

In addition, Internal fixation, when performed, is included in this procedure. External fixation, if performed, may be reported separately. According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure.