# Right hip revision trochanteric femoral nail



## AR2728 (Jul 8, 2013)

Patient had revision of trochanteric femoral nail and removal and exchange of the helical blade.  Would this simply be coded with the open treatment of intertorchanteric femoral fracture 27245?  Op note is attached:

_PREOPERATIVE DIAGNOSIS:
Right prominent trochanteric femoral nail

The right lower extremity was then placed in extension. No traction was placed on the right lower extremity. X-rays were taken and showed a prominent trochanteric femoral nail helical blade into the right hip joint. At this point in time, the right lower extremity was prepped and draped in a sterile manner. 2 separate incisions were made over the prior incisions, one proximal to the greater trochanter, one separately for the helical blade. Dissection continued down proximally until the proximal aspect of the trochanteric femoral nail was identified. Then dissection continued down distally until the helical blade was identified. The helical blade extractor was then placed appropriately. At this point in time the proximal locking screw was then released. The helical blade was then back slapped and removed. At this point in time an 11 mm X 85 mm trochanteric femoral nail screw was then placed. There was good bite when this was seated appropriately. The proximal locking bolt was then locked down on the screw. X-rays were taken and showed appropriate placement of the screw and the appropriate reduction of the intertrochanteric fracture. Once this was done, all extraction devices had been removed. The wounds were copiously irrigated with normal saline._


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## nyyankees (Jul 8, 2013)

AR2728 said:


> Patient had revision of trochanteric femoral nail and removal and exchange of the helical blade.  Would this simply be coded with the open treatment of intertorchanteric femoral fracture 27245?  Op note is attached:
> 
> _PREOPERATIVE DIAGNOSIS:
> Right prominent trochanteric femoral nail
> ...



Since there is no revision code I would recommend 27245 and append a 22 modifier. Use 996.xx codes to show complication. Anyone else?


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## jdemar (Jul 9, 2013)

I agree with 27245-22.


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