Orthopedic Coding Alert
Check Your Payers' 27215-27218 Policies
Rejoice: Pelvic fracture codes spared from CCI 15.0's wrath.
Although CPT 2009 changed the descriptors to pelvic fracture codes (27215-27218) to reflect a "unilateral" procedure, CMS made no edits to these codes.
Why: In the Physician Fee Schedule, CMS does not apply a relative value unit (RVU) value to the 27215-27218 codes because CMS will not reimburse these codes -- ever. Therefore, you won't have any CCI related issues with these codes, but your private payers could have their own guidelines you should follow. Make sure to check with their policies.
Remember: CMS disagreed with the CPT revisions and added their own "bilateral" G codes (G0412-G0415). For more information about these G codes, see "CPT Update: Inclusion of -Unilateral- to Pelvic Fx Repair Codes Could Add $685 to Your Bottom Line" in the Orthopedic Coding Alert, Vol. 12, No. 2, issue.
Orthopedic Coding Alert
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