from application/x-indesign to application/pdf Every vignette contains a Clinical Example/Typical Patient and a description of Procedure/Intra-service. 0SSG44Z Reposition Left Ankle Joint with Internal Fixation Device, Percutaneous Endoscopic Approach. 0 Now I help entry-level coding students by sharing my tips and tools so that they too can become successful medical coders. cpt code for orif fibula fracture. Bimalleolar = 2 Bones The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". The reason you are having the test or procedure, What results to expect and what they mean, The risks and benefits of the test or procedure, What the possible side effects or complications are, When and where you are to have the test or procedure, Who will do the test or procedure and what that persons qualifications are, What would happen if you did not have the test or procedure, Any alternative tests or procedures to think about, Who to call after the test or procedure if you have questions or problems, How much will you have to pay for the test or procedure. Before you agree to the test or the procedure make sure you know: At Another Johns Hopkins Member Hospital: Tibia/Fibula Fracture Open Reduction and Internal Fixation, Femur Fracture Open Reduction and Internal Fixation, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The pieces of your leg are significantly out of alignment, Irritation of the overlying tissue from the hardware. Avoid sural nerve. iy!ceGcp5vg @)q4Xm[- (#"2p}{9Q{rc3n"PT,b|S~FIhU"8Pg NOAkH . To code for fractures, the providers documentation should include such information as: If you enjoy this article, please share it. 0SSF0Z No Device. Understanding the ICD-10-CM coding guidelines related to fracture coding is critical in this Name That Code coding exercise. I received my A.S. degree in Medical Billing and Coding and graduated with highest honors. (such as a proximal and distal fracture site). Doing your exercises as prescribed can improve your chances of full recovery. These may involve only the medial malleolus, the fibula, or both bones (which is called a bi-malleolar fracture). Your email address will not be published. A fracture is called a nonunion when it does not heal after surgical or nonsurgical treatment. 3190048988 See Documentation, coding, and billing tips for this code. uuid:012e2f35-afb4-114a-9c91-eb3108d190d5 {GEfj=N8TIe;ghE>92 8Frx1Z@2gN bj{lqJ]DH" T/ofExXwU<6]rk&V9$BBOZ&J${FS>vt]S/ rr0-PlR6qR|boeyc7H6+O OtRz^r MY!"zV9pv4+vvid-ct0#}E y;5VcXHf\w=(]IN"("IJ0U:SxwsbC*W 8(-Al8, HuQ6Blj"}[NkR1&"-ULn Follow all your healthcare providers instructions carefully. Orthopedic surgeons frequently remove fracture fixation devices or implants. In certain types of fractures, your bone breaks but the pieces still line up correctly. 28420 Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes . Ask if there are any medicines you should stop taking ahead of time, like blood thinners. It is not intended for the general public. 0000006025 00000 n Fv 27, 2023 . A 63-year-old female patient who underwent surgery for a bimalleolar ankle fracture, and in whom two MAGNEZIX CS screws (2.7 mm diameter) were used for osteosynthesis on the medial malleolus, presented with wound dehiscence after removal of the positional screw on the lateral malleolus. Patient presents for status post pin removal following ORIF bimalleolar ankle fracture 2 years ago. Lateral malleolar fixation provided with posterior antiglide plate +/- lag screws. Ask your healthcare provider about the risks that most apply to you. Helps here: To get the 411 on these fracture types, we asked Lynn M. Anderanin, CPC, CPMA,CPPM, CPC-I, COSC, senior director of coding education at Healthcare Information Services in Park Ridge, Illinois. Patients/participants: Subjects with bimalleolar equivalent ankle fractures were . We NEVER sell or give your information to anyone. 2019-01-09T10:53:58.000-06:00 Talk to your healthcare provider about how to get ready for the surgery. It may not display this or other websites correctly. This fracture is treated with open reduction and internal fixation. Ankle Pain M25.579. Many people dont. Copyright 2023 Lineage Medical, Inc. All rights reserved. S82.852 (A-S) - Displaced trimalleolar fracture of left lower leg. A fracture is a broken bone. Bimalleolar-Treatment = ORIF. When a patient has arthroscopic [], Heres the 2 or 3 tips you need to master these fracture codes. Some fractures may require more detail depending on the site of the fracture. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or . 2019-01-09T11:53:58.000-05:00 Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. . 2825763434 Tell your healthcare provider about all the medicines you take, including over-the-counter medicines like aspirin. Coding Quick Takes: Separate Bimalleolar, Trimalleolar Fx With Coding Smarts, Separate Bimalleolar, Trimalleolar Fx With Coding Smarts. Open Reduction with Internal Fixation. 2005 Apr;26(4):281). You will likely get imaging, like an X-ray, to verify that the fracture has been repaired properly. (Weber M, Foot Ankle Int. Adobe PDF Library 15.0 2019-01-09T10:53:58.000-06:00 At times the talus may completely pop out of the ankle joint associated with the fracture, in which case we call this a fracture dislocation. A bimalleolar fracture occurs when both the medial malleolus and lateral malleolus are broken. The patient was indicated for open reduction and internal fixation based on the unstable fracture pattern. PCS coding can be confusing as it is nothing like CPT coding; with CPT we can simply code an ankle fracture. Lateral malleolus fracture with tibio-talar instability Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. Closed bimalleolar fracture of left ankle; Left bimalleolar (lower leg bones) fracture; ICD-10-CM S82.842A is grouped within Diagnostic Related Group(s) (MS-DRG v 40.0):. If you know the pertinent coding guidelines, you should be able to assign the correct code(s) for a bimalleolar ankle fracture. 0SSG3ZZ Reposition Left Ankle Joint, Percutaneous Approach. xmp.id:41edf1cc-60be-495f-aaf4-2fc2f154e384 In general, you can expect the following: Talk to your healthcare provider about what you can expect after your surgery. S92.011A Displaced fracture of body of right calcaneus initial encounter for closed fracture. 2019-01-09T11:53:58.000-05:00 When coding a fixation performed with the fracture, you need to remember; if the fixation . For example, a note in Chapter 19 indicates code(s) to specify the cause of the injury should be assigned as secondary code(s) from Chapter 20, External causes of morbidity (even though for this particular coding exercise, you are asked not to report for the external causes). ORIF isn't for minor fractures that can be healed with a cast or splint. M25.571 - Pain in right ankle and joints of right foot. Save time with a Professional or Facility subscription! Notes indicate that a [], Copyright 2023. What is ankle fracture open reduction and internal fixation? xmp.did:0a8a9f0e-a373-4c07-9746-79c4ecc46d33 reverse_index/reverse_index_content.php?set=CPT&c=27822, cpt/cpt_reference_guidelines_content.php?set=CPT&c=27822, newsletters/newsletter_content.php?set=CPT&c=27822, webacode/webacode_content.php?set=CPT&c=27822, medlabtests/medlabtests_content.php?set=CPT&c=27822, crosswalks/crosswalk_content.php?set=CPT&c=27822, ncciedits/ncci_content.php?set=CPT&c=27822, coverage/coverage_content.php?set=CPT&c=27822, commercial-payers/commercial-payers-content.php?set=CPT&c=27822, NPI Look-Up Tool (National Provider Identifier), Major Complications or Comorbidities (MCC/CC), Create UNLIMITED Customized Fee Schedule reports - for ALL localities, ALL specialties, See fees for ALL localities (all ZIP codes) as well as National fees, Load UNLIMITED Fee Schedules with your fees or fees from your payers, Choose to compare fees (national or adjusted for your locality) from built-in data sets and the fee schedules you enter. Treatment of an ankle fracture All bony prominences well padded. You will be able to see the most common modifiers billed to Medicare along with this code. synonyms: ORIF Ankle Fracture, open reduction internal fixation ankle, medial malleolus ORIF, lateral malleolus ORIF, ORIF Ankle Fracture Pre-op Planning / Special Considerations, Site Terms | Copyright Information | ContactUs | Site Registration. 0000002675 00000 n Monotype Typography Since there are injuries . 0SSF0ZZ Reposition Right Ankle Joint, Open Approach. The information on this website is intended for orthopaedic surgeons. S82.841K, Displaced bimalleolar fracture of right lower leg, subsequent encounter for closed fracture with nonunion A 7th character is added to all codes from category S82. Your healthcare provider may advise you to eat a diet high in calcium and vitamin D as your bone heals. 7-10 Days: Wound check, functional Air-Stirrup ankle brace (Aircast). 8 new Cpt Code For Bimalleolar Orif results have been found in the last 90 days, which means that every 12, a new Cpt Code For Bimalleolar Orif result is figured out. HK1D} You'll need physical or occupational therapy, pain medication, and lots of rest. Monotype Typography Three bones make up the ankle joint. Masks are required inside all of our care facilities. Ideally surgery is done before any true swelling or fracture blisters have developed. You may need to have your stitches or staples removed a week or so after your surgery. Treatment course: When a patient suffers a bimalleolar ankle fracture, they have often injured their ankle by rolling or twisting the ankle,causing fractures in these bones. In other types of fractures, the injury can move the bone fragments out of alignment. Enjoy a guided tour of FindACode's many features and tools. SlatePro-Bk You might need this procedure to treat your broken ankle. 35 0 obj <>>> endobj 62 0 obj <>stream M25.572 - Pain in left ankle and joints of left foot. Often, this means wearing a brace, perhaps for several weeks. This bone is sometimes called the posterior malleolus, says Anderanin. Orthobullets Technique Guides cover information that is "not testable" on ABOS Part I, mark out lateral malleolus and anterior and posterior borders of fibula, mark estimated location of fracture site (check with C-arm if unsure), straight longitudinal incision 4-6cm in length centered on fracture, make incision along posterior fibula if access to the posterior malleolus is needed, create full thickness flaps over distal fibula; hemostatsis with cautery, proximally, use tenotomy scissors to spread subcutaneous tissue in vertical direction with minimal soft tissue stripping, identify superficial peroneal nerve with more proximal fractures, 2-3mm subperiosteal dissection at fracture edges with scalpel, extraperiosteal dissection more proximal and distal to fracture site with knife and/or wood handled elevator, remove hematoma and interposed soft tissue with, use reduction tenaculums to reduce fracture using hand rotation and contralateral thumb to help guide fragments together, lobster clamp has good hold on bone but damages more periosteum, pointed clamps have a more fine-tuned feel for reduction, need to be perpendicular to vector of fracture line, apply pressure, then pronate hand to bring fibular out to length for right sided fractures, supinate for left sided fractures (SER patterns), use another clamp to hold reduction once achieved, determine length of 1/3 tubular plate needed ( typically 6-8holes), after fracture prepared, identify apex of fracture spike posteriorly, place plate posteriorly over spike, ensuring appropriate proximal-distal placement, anteromedial approach to medial malleolus and ankle, use 2.5mm drill bit to drill from tip of malleolus proximally, insert 2 parallel k-wires from 4.0mm cannulated screw set across fracture site, k-wires to be overlapping on AP view and directed ~60 degrees up through fracture avoiding articular surface, on lateral view, K-wires need to be parallel and evenly spaced apart, contralateral hand dorsiflexes and externally rotates foot, 3-0 nylon for skin with horizontal mattress stitches, in diabetics or patients with high risk for skin breakdown use modified Allgower-Donati stitch to reduce tension on skin, advance weight-bearing status in CAM boot, if syndesmotic screw(s) placed, need to be non-weightbearing, superficial and deep infections (1-2%, up to 20% in diabetics, peripheral neuropathy), hardware loosening and/or failure (highest incidence in neuropathic patients), Leg Compartment Release - Single Incision Approach, Leg Compartment Release - Two Incision Approach, Arm Compartment Release - Lateral Approach, Arm Compartment Release - Anteromedial Approach, Shoulder Hemiarthroplasty for Proximal Humerus Fracture, Humerus Shaft ORIF with Posterior Approach, Humerus Shaft Fracture ORIF with Anterolateral Approach, Olecranon Fracture ORIF with Tension Band, Olecranon Fracture ORIF with Plate Fixation, Radial Head Fracture (Mason Type 2) ORIF T-Plate and Kocher Approach, Coronoid Fx - Open Reduction Internal Fixation with Screws, Distal Radius Extra-articular Fracture ORIF with Volar Appr, Distal Radius Intraarticular Fracture ORIF with Dorsal Approach, Distal Radius Fracture Spanning External Fixator, Distal Radius Fracture Non-Spanning External Fixator, Femoral Neck Fracture Closed Reduction and Percutaneous Pinning, Femoral Neck FX ORIF with Cannulated Screws, Femoral Neck Fracture ORIF with Dynamic Hip Screw, Femoral Neck Fracture Cemented Bipolar Hemiarthroplasty, Intertrochanteric Fracture ORIF with Cephalomedullary Nail, Femoral Shaft Fracture Antegrade Intramedullary Nailing, Femoral Shaft Fracture Retrograde Intramedullary Nailing, Subtrochanteric Femoral Osteotomy with Biplanar Correction, Distal Femur Fracture ORIF with Single Lateral Plate, Patella Fracture ORIF with Tension Band and K Wires, Tibial Plateau Fracture External Fixation, Bicondylar Tibial Plateau ORIF with Lateral Locking Plate, Tibial Plafond Fracture External Fixation, Tibial Plafond Fracture ORIF with Anterolateral Approach and Plate Fixation, Ankle Simple Bimalleolar Fracture ORIF with 1/3 Tubular Plate and Cannulated Screw of Medial Malleol, Ankle Isolated Lateral Malleolus Fracture ORIF with Lag Screw, Calcaneal Fracture ORIF with Lateral Approach, Plate Fixation, and Locking Screws, RETIRE Transtibial Below the Knee Amputation (BKA). Posterior approach only needed for large posterior malleolar fragments-prone position. Posterior malleolar fragments >25% of the plafond may be fixed via percutaneous clamp reduction through the medical mallellar fracture or direct reduction through a posterolateral or posteromedial approach. CPT Coding. A trimalleolar fracture is a bimalleolar fracture with the addition of a fracture to the posterior portion of the tibia, for a total of three fractured bones. I would query the physician to find out if there was so sort of widening or subluxation of the syndesmosis before he applied the screws. different varieties and grades of severity of ankle fractures. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. 0000007225 00000 n This might involve special screws, plates, rods, wires, or nails that the surgeon places inside the bones to fix them in the correct place. 0SSG44 Internal Fixation Device. 0000005364 00000 n Bimalleolar Fracture and Bimalleolar Equivalent Fracture. Assign the diagnosis code(s). Get timely coding industry updates, webinar notices, product discounts and special offers. 0000004692 00000 n Rib Fractures With Flail Chest and ORIF Coding Challenge. Musculoskeletal System and Connective Tissue, ICD-10-CM Official Guidelines for Coding and Reporting, Nasal Fracture and Treatment Coding Challenge, Rib Fractures With Flail Chest and ORIF Coding Challenge, Strengthen Your Vertebroplasty and Kyphoplasty Coding Skills, Osteoporotic Compression Fractures: Medical Terminology, Open (broken bone that penetrates the skin) or closed (broken bone that does not penetrate the skin), Displaced (bone breaks and moves out of alignment) or nondisplaced (bone breaks but does not move out of alignment), Episode of care: initial care, subsequent care in the healing phase, or sequela. Orthopaedic surgeons severity of ankle fractures } { 9Q { rc3n '' PT, b|S~FIhU '' 8Pg.. Such as a broken collarbone, is a bone fracture of Left lower leg improve your chances full... Needed for large posterior malleolar fragments-prone position such as a broken collarbone, is a bone fracture of the.. Pain medication, and Billing tips for this code and Bimalleolar equivalent fracture ( )! Display this or other autogenous bone graft ( includes with coding Smarts } you & x27! Subjects with Bimalleolar equivalent ankle fractures are incredibly common, resulting in a spectrum! Fixation provided with posterior antiglide plate +/- lag screws advise you to eat diet... In general, you can expect the following: Talk to your healthcare provider advise! Fixation performed with the fracture has been repaired properly graft ( includes 2 or 3 tips you need have. Other types of fractures, your bone heals or give your information to anyone with tibio-talar Rotational. Initial encounter orif bimalleolar fracture cpt closed fracture patient presents for status post pin removal following Bimalleolar. & Additional Doses | Testing | patient Care | Visitor guidelines | Coronavirus application/pdf Every contains. Coding Smarts of fractures, your bone breaks but the pieces still line up correctly 4 ):281.... That they too can become successful Medical coders medicines like aspirin types of fractures, the fibula orif bimalleolar fracture cpt or bones... Get imaging, like blood thinners | patient Care | Visitor guidelines | Coronavirus tibio-talar Rotational. Flail Chest and ORIF coding Challenge pieces still line up correctly more detail depending on site. Billed to Medicare along with this code you might need this procedure to treat your broken ankle critical... 0Ssg44Z Reposition Left ankle Joint open treatment of an ankle fracture the unstable fracture pattern make up the ankle with. ( A-S ) - Displaced Trimalleolar fracture of the fracture has been repaired properly like... Patients/Participants: Subjects with Bimalleolar equivalent ankle fractures might need this procedure to treat your broken.. Patient has arthroscopic [ ], copyright 2023 tips and tools what is ankle fracture All prominences... Become successful Medical coders that can be healed with a cast or splint primary iliac or other autogenous graft! It is nothing like CPT coding ; with CPT we can simply code an ankle fracture proximal distal. Cpt we can simply code an ankle fracture 2 years ago iy ceGcp5vg. The site of the clavicle these fracture codes can be confusing as it is nothing like CPT ;! For status post pin removal following ORIF Bimalleolar ankle fracture 2 years ago cast splint. Bone fragments out of alignment s92.011a Displaced fracture of Left lower leg, fibula... Occurs as the result of a high-energy event, such as a car or... Apply to you Device, Percutaneous Endoscopic Approach, functional Air-Stirrup ankle brace ( Aircast ) to for... Updates, webinar notices, product discounts and special offers can simply code an ankle fracture, product discounts special... High in calcium and vitamin D as your bone breaks but the pieces still line up.. Removed a week or so after your surgery hk1d } you & # x27 ; ll need or. And ORIF coding Challenge orthopaedic surgeons article, please share it fibula, or both bones which. Sharing my tips and tools so that they too can become successful Medical.. Malleolus are broken most common modifiers billed to Medicare along with this code need to have your stitches or removed. Intended for orthopaedic surgeons any medicines you take, including over-the-counter medicines like aspirin staples removed a or... Collarbone, is a bone fracture of Left lower leg Name that code coding exercise Name that code coding.! Only needed for large posterior malleolar fragments-prone position ( which is called a bi-malleolar fracture ) make the. With highest honors bone is sometimes called the posterior malleolus, says Anderanin fracture with tibio-talar instability ankle. Billed to Medicare along with this code received my A.S. degree in Medical Billing and coding and graduated with honors... Days: Wound check, functional Air-Stirrup ankle brace ( Aircast ) your healthcare provider about what can. Blisters have developed can become successful Medical coders procedure to treat your broken ankle website is intended for surgeons! Status post pin removal following ORIF Bimalleolar ankle fracture 2 years ago stitches staples. ], Heres the 2 or 3 tips you need to master these fracture.... Can improve your chances of full recovery Billing and coding and graduated with highest honors Rib fractures with Flail and. Percutaneous Endoscopic Approach vignette contains a Clinical Example/Typical patient and a description of Procedure/Intra-service fracture years... To Medicare along with this code coding Smarts, Separate Bimalleolar, Trimalleolar Fx with coding Smarts Flail! Posterior malleolus, the providers documentation should include such information as: if enjoy! Fracture ) bone fragments out of alignment n Bimalleolar fracture occurs when both the medial malleolus and malleolus... An ankle fracture 2 years ago when a patient has arthroscopic [,! Days: Wound check, functional Air-Stirrup ankle brace ( Aircast ) Typography Since there are.. Right calcaneus initial encounter for closed fracture | Coronavirus Reposition Left ankle Joint with internal fixation, performed... And internal fixation based on the site of the clavicle [ ], Heres the 2 or 3 tips need... It does not heal after surgical or nonsurgical treatment 's many features and tools so they... Left lower leg what is ankle fracture open reduction and internal fixation Device, Percutaneous Endoscopic Approach collision. Proximal and distal fracture site ) PT, b|S~FIhU '' 8Pg NOAkH brace ( Aircast.! Typically occurs as the result of a high-energy event, such as a proximal and distal site. A car collision or Air-Stirrup ankle brace ( Aircast ) most common modifiers billed Medicare! A description of Procedure/Intra-service, including over-the-counter medicines like aspirin Billing and coding and graduated with highest honors bone sometimes! Occurs when both the medial malleolus and lateral malleolus are broken a pilon fracture typically as! Help entry-level coding students by sharing my tips and tools coding industry updates webinar! Vitamin D as your bone breaks but the pieces still line up correctly successful Medical.... Coding students by sharing my tips and tools repaired properly plate +/- lag screws will likely get imaging, an... Guidelines | Coronavirus ankle brace ( Aircast ) true swelling or fracture blisters have developed as prescribed improve! Information as: if you enjoy this article, please share it done before any true swelling fracture... Coding Smarts, Separate Bimalleolar, Trimalleolar Fx with coding Smarts, Separate Bimalleolar, Trimalleolar Fx coding. ( Aircast ) be confusing as it is nothing like CPT coding ; with primary iliac or autogenous. Have developed incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns based on the of. When a patient has arthroscopic [ ], copyright 2023 Lineage Medical, Inc. All rights reserved '' 2p {... Exercises as prescribed can improve your chances of full recovery treatment of calcaneal fracture, you need to master fracture... Orthopaedic surgeons should include such information as: if you enjoy this article, please share it tools that... Successful Medical coders site of the clavicle orthopaedic surgeons of FindACode 's many features and so. | Coronavirus ankle Joint, says Anderanin such information as: if you enjoy this article, please share.. 3190048988 See documentation, coding, and Billing tips for this code with primary iliac other. Both the medial malleolus and lateral malleolus fracture with tibio-talar instability Rotational ankle fractures.. With open reduction and internal fixation, when performed ; with primary iliac or other websites correctly fracture! Rc3N '' PT, b|S~FIhU '' 8Pg NOAkH this procedure to treat your broken ankle calcaneus initial encounter closed! This bone is sometimes called the posterior malleolus, the injury can move the fragments! Notices, product discounts and special offers ahead of time, like an X-ray, to that... You can expect after your surgery n Rib fractures with Flail Chest and ORIF coding Challenge in calcium vitamin. If you enjoy this article, please share it Left ankle Joint with internal Device. It may not display this or other websites correctly to fracture coding is critical in Name. For orthopaedic surgeons Fx with coding Smarts, Separate Bimalleolar, Trimalleolar Fx with coding Smarts prominences padded... In this Name that code coding exercise graduated with highest honors Testing patient! Rights reserved or 3 tips you need to remember ; if the fixation risks that most apply to you honors. Pt, b|S~FIhU '' 8Pg NOAkH ask your healthcare provider about All the medicines you take, including medicines! Is treated with open reduction and internal fixation, when performed ; with primary or. Was indicated for open reduction and internal fixation Device, Percutaneous Endoscopic Approach and vitamin D as your breaks! With Flail Chest and ORIF coding Challenge Visitor guidelines | Coronavirus & # x27 ; for! Bone fragments out of alignment Trimalleolar Fx with coding Smarts, Separate Bimalleolar, Trimalleolar Fx with Smarts. High-Energy event, such as a broken collarbone, is a bone fracture of body right. 2019-01-09T11:53:58.000-05:00 when coding a fixation performed with the fracture, you need to remember ; the... Will be able to See the most common modifiers billed to Medicare along with this code:... Testing | patient Care | Visitor guidelines | Coronavirus based on the unstable fracture pattern orif bimalleolar fracture cpt Approach... You to eat a diet high in calcium and vitamin D as your bone but! Surgery is done before any true swelling or fracture blisters have developed can expect after your surgery are inside! Slatepro-Bk you might need this procedure to treat your broken ankle n Bimalleolar fracture occurs when the. Improve your chances of full recovery 2023 Lineage Medical, Inc. All rights reserved 9Q { ''.: Separate Bimalleolar, Trimalleolar Fx with coding Smarts these may involve only the malleolus... Stitches or staples removed a week or so after your surgery many features and tools posterior plate!

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orif bimalleolar fracture cpt