![]() Bimalleolar Fracture and Bimalleolar Equivalent FractureĪ bimalleolar fracture occurs when both the medial malleolus and lateral malleolus are broken. Typically, the surgical repair is done by placing screws in the lower tibia from front to back. Surgical fixation is required if the fracture is large and out of place. Treatment may involve wearing a short leg cast or a removable brace. Many posterior malleolus fractures are small and do not require surgery. This is due to attachments of ligaments between the two bones. Most posterior malleolus fractures are associated with another injury, usually a fracture of the lateral malleolus. Because MRI scans are more sensitive than other imaging tests, they may be used to detect ligaments injuries.Ī posterior malleolus fracture is a fracture of the back of the tibia. MRI scans provide high-resolution images of both bones and soft tissue structures, like ligaments. It is helpful in evaluating the extent of the injury to the ankle joint. A CT scan provides detailed cross-sectional X-ray images of the ankle and is sometimes done to further evaluate the ankle injury. This X-ray is done to determine if the syndesmosis (area between the lower tibia and fibula) is injured.Ĭomputed tomography (CT) scan. Your doctor may also take X-rays of the leg and foot to make sure there are no other injuries.ĭepending on the type of ankle fracture, your doctor may put pressure on the ankle and take a special X-ray called a stress X-ray. They can also show how many pieces of broken bone there are. They can show where the bones are broken and if any of the bones are out of place (displaced). X-rays provide images of dense structures such as bone. X-rays. Most ankle fractures can be diagnosed with X-rays. If your doctor suspects an ankle fracture, they will order one or more of the following imaging tests to diagnose and evaluate the fracture It is appropriate to use initial evaluation and treatment suffix “A” when the patient has been transferred from another facility to a higher level trauma facility for active management of the fracture.įor additional information on ICD-10 coding for emergency medicine, visit the ACEP Reimbursement page.After discussing your medical history and how the injury occurred, your doctor will do a careful examination of your ankle, lower leg, and foot. Initial care 7 th character codes “A” (closed fracture) or “B” (open fracture Gustilo Type I or II, or unspecified) or “C” (open fracture Gustilo Type IIIA, IIIB, or IIIC) indicate the patient is receiving active treatment for the fracture. Multiple fractures are sequenced by the severity of the fracture.If the description does not specify the type of open fracture, the coder will default to Type I/II.If the description does not specify displaced or non-displaced, the coder will default to displaced.If a fracture description does not specify open or closed, the coder will default to closed.III C: Any open fracture requiring vascular repair to save the limb, regardless of the degree of soft tissue injury.
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