AHA Coding Clinic® for HCPCS - 2020 Quarter 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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Article Overview
This premium coding article reviews a Lisfranc fracture-dislocation case and frames the coding question around combined operative management of the affected tarsometatarsal joints. It is intended for coders and billers working with orthopedic trauma and foot surgery records who need to understand the type of CPT guidance covered, including how the article approaches a combined reduction-and-fusion scenario.
Why This Topic Matters
Lisfranc injuries can involve multiple structures in the midfoot and may be documented with overlapping operative techniques. This article matters because it addresses how the case is analyzed for CPT assignment in a complex surgical setting.
What You Will Learn
- How a Lisfranc fracture-dislocation case is framed for CPT coding review.
- What types of operative procedures are discussed in a combined midfoot surgery scenario.
- How the article approaches coding questions involving reduction and fusion in foot surgery documentation.
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Who Should Read This
- CPT coders
- medical billers
- orthopedic surgery coders
- trauma coding professionals
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