# Revision Hip Replacement/Femur Fracture



## cwilson3333 (Jan 11, 2012)

Pre-op Dx:
Periprosthetic right femur fracture
Total Hip Replacement 4 months prior
With Shortening Right Lower Extremity

Procedure:
1. Revision of Right Femoral Stem to Restoration Modular Stem
2. Extended trochanteric osteotomy for implant removal

Questions re coding:
1. CPT 27138 for revision femoral stem

Implant removal took 1 hour to disimpact, so extended trochanteric osteotomy done.
Cables placed around femoral stem to protect against further fracture
Do I charge for "fracture tx" and what CPT or do I modify 27138 with "22" for 
the additional work?

Need some direction on correct coding.

Thanks,

CW


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## cwilson3333 (Jan 12, 2012)

*hip revision/femur fracture*

Still waiting for "someone" to reply.


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## abazcoder (Jan 12, 2012)

In my experience, the insurances will most likely not pay for both
27138 and an Osteotomy as well (although they are not bundled)

I would be more inclined to bill the 27138 with a -22 modifier and as long as the documentation shows the surgeon spent an excessive amount of time to accomplish the revision and it warrants the 22.

IMO....good luck


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## cwilson3333 (Jan 13, 2012)

*Hip Replacement/Hip Fracture*

Thanks,

I was thinking along those lines, too.  This surgery ended up being a 5-hour surgery, so I think the 22 modifier definitely should be added.

CW


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