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The CPT® Code 27768 refers to the closed treatment of a posterior malleolus fracture that involves manipulation. This procedure is indicated when a fracture of the posterior malleolus, which is a bony prominence located at the back of the ankle, is assessed for its stability, size, location, and the number of bone fragments present. The physician conducts a thorough evaluation, often following separately reportable radiographic studies, to determine the best course of action for treatment. In contrast to CPT® Code 27767, which describes closed treatment without manipulation for fractures that are in anatomic alignment, CPT® Code 27768 is specifically utilized when the fracture is displaced and requires manual manipulation to restore proper alignment. During the procedure, the physician performs a closed reduction, which involves manually repositioning the displaced bone fragments into a more optimal position to facilitate healing. This manipulation may include techniques such as dorsiflexion of the foot to achieve the desired alignment. After the reduction is completed, the correct anatomical alignment is confirmed through radiographic imaging. To maintain the alignment of the fracture during the healing process, a cast is applied. It is important to note that if open treatment is necessary, as described in CPT® Code 27769, a different approach involving surgical intervention would be taken, which includes making an incision and potentially using internal fixation devices. Overall, CPT® Code 27768 is essential for accurately coding the closed treatment of a posterior malleolus fracture that requires manipulation to ensure proper healing and alignment.
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The closed treatment of a posterior malleolus fracture with manipulation, as described by CPT® Code 27768, is indicated for the following conditions:
The procedure for closed treatment of a posterior malleolus fracture with manipulation involves several key steps:
Post-procedure care following the closed treatment of a posterior malleolus fracture with manipulation includes monitoring the patient for any signs of complications, such as increased pain, swelling, or loss of function. The physician may schedule follow-up appointments to assess the healing progress through additional radiographic evaluations. Patients are typically advised on how to care for the cast, including keeping it dry and avoiding putting weight on the affected limb until cleared by the physician. Rehabilitation exercises may be recommended once the fracture has healed sufficiently to restore mobility and strength to the ankle joint.
| Short Descr | CLTX POST ANKLE FX W/MNPJ | Medium Descr | CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ | Long Descr | Closed treatment of posterior malleolus fracture; with manipulation | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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