AHA Coding Clinic® for HCPCS - 2010 Issue 3; ASK the EDITOR

Malunion, Open Reduction, Internal Fixation

This patient had a previous injury to his left small finger. X-rays now reveal the patient has a severely displaced fracture of the head of the proximal phalanx. The patient presents to have an open reduction, internal fixation (ORIF) of an early malunion of the left small finger, proximal phalanx head fracture. We have read in the April 2009, CPT Assistant that if a malunion code does not exist, we are to assign the fracture code and append modifier 22, Increased Procedural Services. Does this guideline apply to facility reporting? What are the appropriate codes for this fracture treatment and should a modifier be appended? ...

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