Unspecified injury of left foot, initial encounter. 2016 2017 2018 2019 Billable/Specific Code. S99.922A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM S99.922A became effective on October 1, 2018.
initial encounter. The ICD-10 codes for LisFranc injury are: S93.324 – Dislocation of tarsometatarsal joint of right foot, lisfrance fracture-dislocation, and hematoma 2, initial encounter S93.325A – Dislocation of tarsometatarsal joint of left foot, pelvis and thigh with mcc, strain and dislocation except femur, DPM, initial encounter
This type of injury can be consistent with a fracture accompanied by dislocation of the tarsometatarsal (Lisfranc) joint located in the middle of the foot. This injury can be caused by a high-energy blow to the foot or by a twisting fall.
Lisfranc's ligament arises from lateral surface of medial cuneiform and inserts onto the medial aspect of the second metatarsal base near the plantar surface. It tightens with pronation and abduction of the forefoot. (de Palma, Foot Ankle Int 1997;18:356)
The ICD-10 codes for LisFranc injury are: S93. 324 – Dislocation of tarsometatarsal joint of right foot, S93.
CPT code 28615 would be reported for the fixation of the dislocation. CPT code 28485-59 would be reported three times to represent each metatarsal fracture, per CPT description of the code.
A Lisfranc joint injury is a type of injury to the bones or ligaments, or both, in the middle part of your foot. In a Lisfranc joint injury, there is usually damage to the cartilage covering these bones. In the middle region of your foot (midfoot), a cluster of small bones form an arch.
The Lisfranc ligament is a large band of plantar collagenous tissue that spans the articulation of the medial cuneiform and the second metatarsal base. While transverse ligaments connect the bases of the lateral four metatarsals, no transverse ligament exists between the first and second metatarsal bases.
Lisfranc ORIF / Arthrodesis Technique 28615.
The tarsometatarsal joint is an articulation (Lisfranc joint) that consists of the three cuneiforms and the cuboid as they join with the five metatarsals. Transverse ligamentous supports span the base of the metatarsals with the exception of the first and second metatarsals.
The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalry men, in 1815, after the War of the Sixth Coalition.
X-rays. Broken bones and the position of the bones can be seen in an X-ray image. An X-ray also can show the alignment of the Lisfranc joint. Any change in the normal alignment of the joint may suggest injury to the ligaments.
A Lisfranc sprain is a rare condition that's often misdiagnosed. When accompanied by a fracture, this joint injury accounts for less than 1% of all fractures per year. It's characterized by pain in the middle of the foot, abnormal swelling, and the inability to put weight on the injured foot.
Lisfranc surgery is to repair broken or dislocated bones in the midfoot, or the middle part of the foot.
LisFranc Anatomy. Lisfranc's ligament arises from lateral surface of medial cuneiform and inserts onto the medial aspect of the second metatarsal base near the plantar surface.
If any concern for compartment syndrome, check compartment pressures. Absolute pressure >40mmHG indicates need for fasciotomy.
A/P view: medial border of second metatarsal is in line with medial border of middle cuneiform. 1st MT aligns with medial and lateral borders of medial cuneiform. 1st 2nd intermetatarsal space is continuous with the intertarsal space of the medial and middle cuneiforms. (Stein Foot Ankle 1983;3:286). Distance between 1st and 2nd MT bases up to 3mm considered normal (Coss, Foot Ankle Int 1998;19:537).
indirect injuries result from twisting and axial loading of the extremely plantar-flexed foot.
Stress radiographs indicated if tenderness and swelling noted on exam. This can be done under ankle block. A/P with forefoot in abduction, lateral with forefoot in plantar flexion while midfoot/hindfoot held in neutral