# Re-amputation



## MichelleWerwinski (Sep 14, 2010)

Pt. had a BKA, than a knee disarticulation and now presents for a AKA all on the same leg.  Do I use the re-amputation or the AKA 27590 with a
79 modifier for furthering of disease?  I billed for the BKA (27880-27888), then the 27598 for Knee Disarticulation.


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## Bella Cullen (Sep 14, 2010)

I think 27590 but with a 58 modifier because this is related to the previous surgery.


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## jdemar (Sep 14, 2010)

If all in the global I would have done 27880-RTor LT
                                                     27598-58, RT or LT
                                                     27590 -27592 58, RT or LT, the 58 modifier is for 

1.  Planned or anticipated (staged) OR

2.  MORE EXTENSIVE THAT THE FIRST or

3.  Therapy following a surgical procedure.

Depends if it's in the global, diagnosis etc....FYI

58- resets the global and 100% reimbursement is expected of allowable.
78- global stays with the orginal case, 50-70% reimbursement is expected of allowable.
79- is not for complications and MUST HAVE A DIFFERENT SX and MAKE IT THE PRIMARY DIAGNOSIS expect 100% of allwable.


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## MichelleWerwinski (Sep 14, 2010)

*Re-Amputation code 27596*

When would this code be used?


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## Bella Cullen (Sep 14, 2010)

I would use 27596 if doc has to do a re amp again after the AKA 27590-27592. 
But since the first one was BKA then AKA that is why I would do it like that.


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## jdemar (Sep 15, 2010)

as Bella said for the re-amputation they have to be under the primary surgery site/code and there are two re-amps....1.  secondary closure or scar revision is with no bone involvement and 2. re-amputation, when more bone is taken, again under each individual code .....AKA  27590, 27594, 27596   or   BKA 27880, 27884, 27886.    Hope this helps.


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