A 72-year-old female presents to her PCP with complaints of a sore, swollen left ankle. The patient has severe osteoporosis and Type II diabetes and states that she "tripped last night on her way to the bathroom" and thinks she sprained her ankle. Her PCP orders an x-ray of her left ankle, and the report showed a pathologic closed fracture of the left lateral malleolus. Closed treatment of the lateral malleolus is performed by an orthopedic surgeon. Select the appropriate CPT and ICD-10-CM codes for the surgeon.

Question

Quizplus · Accepted Answer

The correct CPT code for closed treatment of a lateral malleolus fracture without manipulation is 27786, and the modifier -LT indicates that the procedure was performed on the left side. The ICD-10-CM code M80.072A specifies a pathologic fracture of the left ankle due to osteoporosis, with a current fracture, initial encounter, which aligns with the patient's condition and the nature of the injury.

A 72-Year-Old Female Presents to Her PCP with Complaints of a Sore