25607 vs 25608 Extra-articular vs Intra-articular distal radius fracture and treatment

My op report states ORIF intra-articular radius fracture - BUT it is not 2 fragments or 3 fragments. When I select 25607 then DX code S52.572A is not valid. But there are not 2 fragments listed to use cpt code 25608

How would someone code this note? Please and thank you!

PREOPERATIVE DIAGNOSIS:

Left distal radius fracture, intra-articular, displaced.

POSTOPERATIVE DIAGNOSIS:
Same

PROCEDURE

Open reduction, internal fixation Left distal radius fracture.

DESCRIPTION OF PROCEDURE
She was brought into the operating suite, placed in the supine position on the operating table. Anesthetic was placed. The upper extremity was prepped and draped with chlorhexidine and alcohol in the standard draping technique. The arm was exsanguinated with an Ace wrap. The tourniquet was inflated to 250 mmHg.

A volar radial incision was made over the wrist. Careful dissection was carried out. The FCR tendon sheath was incised, the tendon retracted ulnarly and the floor of the sheath incised. The pronator quadratus was released and elevated off the distal radius. The fracture was encountered. It was
carefully reduced, held in place and fixed with a DVR plate
fixed with locking screws proximally and locking pegs distally. Reduction anatomic . Hardware was in good position.

The tourniquet was released. Hemostasis was achieved with electrocautery. The wound was irrigated. The pronator was repaired with 0 vicryl. The FCR tendon sheath was repaired with 2-0 Vicryl running suture. The skin and subcutaneous were closed with 3-0 nylon horizontal mattress sutures. A sterile dressing was applied.

The patient was placed in a well-padded volar splint and awakened.

Comments

  • edited June 2017
    You should use 25608, It's intra-articular, not extra-articular, so 25607 does not apply.

    A fracture has at least 2 fragments. Picture a simple, displaced fracture--you have an upper/proximal fragment, and a lower/distal fragment, and the fragments are separated by the break in the bone. The surgeon brings those two fragments back into proper position, then uses a plate or fixation device to hold the two fragments together.

    If the fracture is comminuted, then there would be three or more fragments.


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