AHA Coding Clinic® for HCPCS - 2020 Issue 3; Ask the Editor

Lisfranc fracture/dislocation

Patient presents for treatment of a left Lisfranc fracture dislocation. The first through fifth tarsometatarsal joints were dislocated and there was a fracture at the base of the second tarsometatarsal joint. Initially closed reduction was performed to align all of the dislocated tarsometatarsal joints. Due to the severity of the injury to the ligaments, cartilage and the fracture, it was decided to perform arthrodesis of the first and second tarsometatarsal joints. Incisions were made between the affected joints and continued deep through the subcutaneous tissue. The first and second tarsometatarsal joints were reduced and allograft chips, screws and fusion plates were utilized to hold each joint in its fused position. If a patient suffers a Lisfranc injury and a fracture is noted at the base of the tarsometatarsals, what codes are assigned when a combined open reduction internal fixation (ORIF) and fusion is performed? ...

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