# Help with 27245



## FREEPONY (Apr 22, 2008)

My physician needs to go in to revise the original procedure 27245.  He is not taking out the implant but revising the nail placement and position.    How would you code this.  I can't seem to find a cpt code for this.  I thought of using the original procedure but using the modifier 52 for reduced services.  This is a Medicare patient.


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## PatriciaCPC (Apr 25, 2008)

I would assume changing the position of the nail, but still using the *same nail*... the surgeon would have to remove it, drill again, and re-implant it. I would use the unlisted 27299 - cross-referencing the 27245.
(if it is during the post op period, don't forget the 78 modifier).

However if your surgeon is using a *new nail*, I would code the removal of the implant 20680 and the implant procedure 27245. 
Even though the procedures sometimes change once a patient is on the operating table, your surgeon should know best what he 'plans' for the pt. Ask them to be more specific... it may guide you better. Have a good weekend!


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## mbort (Apr 28, 2008)

you may also want to see 27033 for the removal/revision of the foreign body (ie:hardware) since this is deeper in the joint and not easily accessable through soft tissue alone.  The dx crosscoder allows for complications of orthopedic implant issues.


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