# Op Report



## nyyankees (Nov 23, 2009)

I have an op that I'd like an opinion on:

Operation: In Situ Screw Fixation for Slipped Capital Femoral Epiphysis

Procedure:
We placed a guide wire on the anterior aspect of the femoral neck along the intertrochanteric line. This was advanced using AP and lateral images so that it was centered in the femoral neck and in the epiphysis. We crossed the physis with it and got the pin into a few mm within the articular surface.

We now measured the length of the embedded pin and now made an approximately one cm incision overlying the pin. We now drilled over the guide wire and placed the appropriate length fully threaded large AO cannulated screw over the guide wire.

The hip was now put through a full range of motion under fluoroscopic guidance. The screw did not enter the hip joint at any location. It was in a good position in all respects. The guide wire was removed.

He originally used 27176 but since he didn't use "traction" that was not a good code. Then with 27177 he states he did not do an "open" procedure. But he did make a "one cm incision". Any thoughts are appreciated. Thanks.


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## FTessaBartels (Nov 23, 2009)

*27176*

This is NOT my area of expertise, but ...

The semi-colon tells us that *this *code does *NOT* include the traction. It sometimes helps if you completely write out the entire code:

27175 Treatment of slipped femoral epiphysis*;* by traction, without reduction

27176 Treatment of slipped femoral epiphysis*;* by single or multiple pinning, in situ

(Emphasis added by FTB for illustration purposes)

F Tessa Bartels, CPC, CEMC


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## khopstein (Nov 23, 2009)

I think 27176 would be appropriate.  It does not include traction, only 27175 does.  The semicolon separates the 27175 and 27176.  Therefore, 27176 would really read as "treatment  of slipped femoral epiphysis; by single or multiple pinning, in situ". I hope this helps.


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## jdemar (Nov 24, 2009)

I agree with 27176.


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## nyyankees (Nov 24, 2009)

Thank you all!!! I agree...will spk with my Dr


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