From the Research
The most common billing codes for broken leg surgery include CPT codes 27506 to 27514 for femur fractures, 27758 to 27769 for tibia/fibula fractures, and 27840 to 27848 for ankle fractures, as supported by recent studies 1. When it comes to billing for broken leg surgery, it's essential to use the correct codes to ensure proper reimbursement.
- CPT codes 27506 to 27514 are used for femur fractures,
- 27758 to 27769 for tibia/fibula fractures, and
- 27840 to 27848 for ankle fractures. These codes vary based on the specific procedure performed, such as open reduction internal fixation (ORIF), closed reduction, or external fixation. ICD-10 diagnosis codes typically start with S82 for lower leg fractures, with additional digits specifying the exact location and type of fracture. For example, S82.101A indicates a closed fracture of the upper end of the right tibia with initial encounter, as seen in studies like 2. Modifiers may be necessary to indicate laterality (right or left leg) or for special circumstances. When billing, documentation must include the fracture type, location, treatment method, and any complications, which can affect morbidity, mortality, and quality of life, as highlighted in 1. Insurance coverage varies by plan, with most requiring prior authorization for surgical procedures. Accurate coding is essential for proper reimbursement and to avoid claim denials or audits, ultimately impacting patient outcomes and quality of life.