CPC Chapter Review - Musculoskeletal - Medical Coding Course Review and Practice Questions

Summary

This video guides viewers through the process of coding for a patient undergoing open reduction and bone grafting for a non-union of a tibial fracture. The focus is on determining the correct CPT and ICD-10-CM codes, particularly for the left lateral condyle tibial fracture with a non-union. It explains the steps of bone grafting, the use of cancellous bone from the iliac crest, and the application of interfragmentary compression. The video emphasizes selecting the right codes and modifiers, providing a practical example to improve musculoskeletal system coding skills.

Takeaways

• 😀 The procedure discussed involves open reduction and bone grafting for a non-union of the left tibia.
• 😀 The patient previously had a Type 3a left lateral condyle tibial fracture treated with external fixation.
• 😀 A bone graft was harvested from the iliac crest, and 18 grams of cancellous bone was used for the procedure.
• 😀 The fracture site was exposed, cleaned, osteotomized, and repositioned during the surgery.
• 😀 Interfragmentary compression was applied using three screws to stabilize the fracture site.
• 😀 The code 27274 is used for open reduction of a tibial non-union with bone grafting from the iliac crest.
• 😀 The term 'autograft' refers to a bone graft harvested from the patient’s own body, as seen in this case.
• 😀 The ICD-10-CM code S82.122N is appropriate for a displaced lateral condyle tibial fracture with non-union at a subsequent encounter.
• 😀 The left tibia was specifically mentioned, so the LT modifier should be added to the CPT code 27274.
• 😀 The term 'non-union' is crucial in selecting the correct codes, indicating the failure of the fracture to heal properly.
• 😀 The coding approach requires attention to the type of fracture, the procedure performed, and the specific details of the patient's encounter.

Q & A

What is the primary procedure discussed in the transcript?

The primary procedure discussed is the open reduction of a non-union fracture of the left proximal tibia, along with bone grafting.

Why was the bone grafting performed in this case?

Bone grafting was performed to assist in the healing of the non-union of the left proximal tibia by using cancellous bone harvested from the iliac crest.

What type of bone graft was used in this procedure?

An autograft was used, meaning the bone was harvested from the patient's own body, specifically from the iliac crest.

What is the purpose of the interfragmentary compression applied with screws?

Interfragmentary compression with screws is used to stabilize the fractured bone pieces and encourage proper healing by keeping the bone fragments in place.

What does the term 'non-union' refer to in the context of this case?

Non-union refers to a condition where a bone fracture has not healed properly or fully after an adequate period of time, despite medical intervention.

How is the term 'open reduction' used in the context of this surgery?

Open reduction refers to the surgical procedure where the fracture site is exposed and the bone fragments are manually repositioned to promote healing.

What does the ICD-10 code 'S82.122N' represent in this case?

The ICD-10 code 'S82.122N' represents a displaced fracture of the lateral condyle of the left tibia with non-union, which is a subsequent encounter for the open fracture type 3A.

What is the difference between '27224' and '27222' in the CPT coding system?

The code '27224' is for open reduction of non-union with iliac or other autograft, while '27222' is for open reduction of non-union without the use of a graft. '27224' is the correct code for this procedure due to the use of an autograft.

Why is the 'LT' modifier used with the CPT code '27274'?

The 'LT' modifier is used to indicate that the procedure was performed on the left side of the body, specifically on the left proximal tibia.

What would be the appropriate ICD-10 code if the fracture were open and not a subsequent encounter?

If the fracture were open and not a subsequent encounter, the ICD-10 code would be 'S82.102C', which represents an unspecified fracture of the upper end of the left tibia during the initial encounter for an open fracture type 3A.