ORIF distal tibia fracture not involving ankle joint

Created Jul 2018
Reviewed Dec 2019

Query

A patient was admitted for open reduction and internal fixation (ORIF) of fracture of distal tibia (documented not involving ankle).  What is the appropriate code for this procedure as there is no specific index entry?
Should we assign 47566-01 [1510] Open reduction of fracture of shaft of tibia with internal fixation or 47600-01 [1539] Open reduction of fracture of ankle with internal fixation of diastasis, fibula or malleolus?

Reduction
- fracture
- - ankle (closed) 47597-00 [1537]
- - - open 90558-00 [1539]
- - - - with internal fixation
- - - - - malleolus 47600-01 [1539]
- - - - - - with diastasis or fibula 47603-01 [1539]
...
- - tibia, tibial
- - - plateau
- - - - lateral (closed)
- - - - - open 47549-00 [1508]
- - - - - - with internal fixation 47549-01 [1508]
...
- - - shaft (closed) 47564-00 [1509]
- - - - open 47570-00 [1510]
- - - - - with internal fixation (cross) (intramedullary) 47566-01 [1510]
- - - upper end (head) (proximal) — see Reduction/fracture/tibia, tibial/plateau

Response

As the fracture does not involve the ankle the only option available in ACHI is 47566-01 [1510] Open reduction of fracture of shaft of tibia with internal fixation.  The specific site (distal) of fracture is captured in the disease code and can be captured by adding free text on the procedure code descriptor.

 

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