Orthopedic Coding Alert
Append -53 Only With Anesthesia
Question: We were about to start anesthesia on a total knee replacement (27447) patient when her heart rate suddenly dropped. The orthopedist canceled the procedure and moved the patient from the operating room to an inpatient room, where a cardiologist evaluated her condition. Should we append modifier -53 to 27447 for our portion of the canceled procedure? Delaware Subscriber Answer: Modifier -53 (Discontinued procedure) is not appropriate because you canceled the procedure before administering anesthesia. The June 1997 CPTAssistant advises, "This modifier is not used to report the elective cancellation of a procedure prior to a patient's anesthesia induction and/or surgical preparation in the operating suite."
Because you admitted the patient to the hospital and requested the cardiologist's consultation, you should report only an initial hospital care code (99221-99223).
Orthopedic Coding Alert
- Modifiers Can Make or Break Surgical X-Ray Claims
If you perform medically necessary x-rays before and after surgery for instance, to confirm implant [...] - Coding Case Study:
Report Only One E/M Code on Hospital Admit Date
Outpatient E/M visits sometimes uncover problems so severe that the orthopedist orders immediate emergency surgery. [...] - Modifier -57 At a Glance
For elective cases, orthopedists normally make surgical decisions days or weeks before the surgery, but [...] - NCCI Scopes New Knee Surgery Edits
Version 9.1 of the National Correct Coding Initiative (NCCI), which took effect April 1, bundles [...] - You Be the Coder:
Weaver-Dunn Procedure
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Reader Question:
Dont Report E/M for Warfarin Visit
Question: Our orthopedists often give patients warfarin following hip and knee replacement surgery. We usually [...] - Reader Question:
Append -53 Only With Anesthesia
Question: We were about to start anesthesia on a total knee replacement (27447) patient when [...] - Reader Question:
Tendon Injections Differ From TPIs
Question: What is the difference between the codes in the 20550-20553 series? I know the [...] - Reader Question:
Use -47 If Surgeon Performs Anesthesia
Question: I administered anesthesia to a patient before performing a bunionectomy and Chevron osteotomy. How [...] - Reader Question:
Report 62310-62311 for Single Epidurals
Question: Should we report 62318 or 62319 when the orthopedist percutaneously inserts a catheter to [...] - Reader Question:
Append -22 for TKA Conversion
Question: How should we report conversion of a total knee arthroplasty (TKA) for a patient [...] - Reader Question:
Report 99141 for Conscious Sedation
Question: We recently treated a dislocated shoulder while we had the patient under conscious sedation. [...] - Correction:
Graft Harvest/Insertion With 25447
The February 2003 Orthopedic Coding Alert article "Rule of Thumb: 25447 Includes Trapezium Excision" should [...]
