Multiplane: You should report 20692 (Application of a multiplane [pins or wires in more than 1 plane], unilateral, external fixation system [e.g., Ilizarov, Monticelli type]). Coders may find deciding between uniplanar and multiplanar codes to be tricky.
Uniplane and multiplane external fixation systems play an important role in providing stability to the area while the bones heal. Such systems ensure that the displaced sections of bone are kept in place at all times. The concept is simple, yet effective. Metal pins and wires are attached to certain areas of the bone away from the actual fracture.
In PCS, the application of fixation of a bone has a code for each bone. You will find these codes under insertion; it is not called a fixation with PCS Coding. Remember, if you are working on a fracture, you are working with the bone, not the joint.
CPT 20692: “Application of a multiplane (pins in more than one plane), unilateral, external fixation system.”
External fixation systems are devices made of metal rods, wires, and pins designed to provide stability to fractured leg bones. There are several types, but the most common are uniplane and multiplane systems. The human body has an amazing ability to heal itself, especially with regards to fractured bones.
A multiplane circumferential frame solves many of the technical, biomechanical, physiologic, and psychologic problems connected with external skeletal fixation. Predrilling of pins, uniplane adjustment capabilities, and titanium and aluminum alloy materials provide adaptability, adjustability, and compatibility.
Unilateral external fixator is commonly used to stabilize initial fractured bone for polytraumatised patients, which is simple and effective method. The stiffness property of the external fixator has a great influence on the local biomechanical environment of bone tissue.
Uniplane fixators use thicker, more solid pins for fixation than multiplane fixators, Mallon says. Ring fixator pins are much narrower, and the surgeon places them under tension, he says.
Fixation can be: Internal: Involves the use of devices internally (under the skin) positioned within the patient's body. External: The devices are screwed into fractured bones to exit the skin and are attached to a stabilizing structure outside the body.
With external fixation, pins are inserted through the skin into the bone and held in place by an external frame. The usual indications are open fractures such as a tibia fracture which requires dressings or attention to a wound or flap. It can also be used with closed fractures e.g. unstable radius fracture.
These devices may consist of external elements (bars, rods), connector elements (clamps), and anchorage elements (pins, screws, wires). These devices are commonly used to heal bone fractures in the forearms, legs, hands, and feet following traumatic injury.
Because pins are inserted into bone, external fixators differ from casts and splints which rely solely on external support. External fixation is often used to hold the bones together temporarily when the skin and muscles have been injured. In many cases, external fixation is used as a temporary treatment for fractures.
Other mechanical complication of internal fixation device of unspecified bone of limb, initial encounter 1 T84.199A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 Short description: Mech compl of int fix of unsp bone of limb, init 3 The 2021 edition of ICD-10-CM T84.199A became effective on October 1, 2020. 4 This is the American ICD-10-CM version of T84.199A - other international versions of ICD-10 T84.199A may differ.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code.
Fusions happen on joints; insertions for a fracture are coded to the specific bone and will be found in the section under lower bones .
In the examples below, the repair or release is the root procedure for a displaced ankle joint.
Example: Closed reduction of fracture is coded to the External approach.
In the musculoskeletal system, the fourth character represents the body part the procedure was performed on; the tibia in the codes below are represented here by the character G in the fourth position.
PCS does offer "Fusion" (Operation G). Therefore, a fusion of the ankle joint does have its own code and can be found in the lower joints section representing the fourth character.
When coding a fixation performed with the fracture, you need to remember ; if the fixation was done internally it may be included with CPT and the external fixation is coded separately using the codes below.
Fusions happen on joints; insertions for a fracture are coded to the specific bone and will be found in the section under lower bones .
PCS does offer "Fusion" (Operation G). Therefore, a fusion of the ankle joint does have its own code and can be found in the lower joints section representing the fourth character.
Example: Closed reduction of fracture is coded to the External approach.
In the musculoskeletal system, the fourth character represents the body part the procedure was performed on; the tibia in the codes below are represented here by the character G in the fourth position.
When coding a fixation performed with the fracture, you need to remember ; if the fixation was done internally it may be included with CPT and the external fixation is coded separately using the codes below.
Uniplane and multiplane external fixation systems play an important role in providing stability to the area while the bones heal. Such systems ensure that the displaced sections of bone are kept in place at all times.
External fixation systems are devices made of metal rods, wires, and pins designed to provide stability to fractured leg bones. There are several types, but the most common are uniplane and multiplane systems. The human body has an amazing ability to heal itself, especially with regards to fractured bones.
External fixators are usually used for tibia (shin bone) and distal radius fractures. The distal radius is one of the ten bones that make up the wrists and the most likely to be fractured in a wrist injury. The systems are not normally used for fractures of the femur (thighbone), humerus (bone from elbow to shoulder), and the forearms.
One of the most common problems with this type of fixation system is that it may not provide sufficient stability to the bones. There is also a risk of infections developing at the area where the pins are located. Such infections are referred to as pin tract infections.