Orthopedic Coding Alert
Component of THR
Michigan Subscriber
Answer: Under these circumstances, it would be appropriate to report 27134 (revision of total hip arthroplasty; both components, with or without autograft or allograft) with modifier -52 (reduced services). Because only the femoral head is being replaced and the existing stem is being left in place, the procedure has been reduced, and you will need to convey this information to the carrier in the form of a letter when you submit the claim. Remember to state what percentage of the reimbursement for 27134 you feel you are entitled to rather than leaving it to the carriers discretion. Submit the higher paying code (27134) and ask for a reduction as opposed to submitting the lower paying code 27137 (acetabular component only, with or without autograft or allograft) and asking the carrier to increase their fee. You are more likely to achieve the desired level of reimbursement as carriers are more amenable to offering a reduced level of reimbursement than an increased one.
Orthopedic Coding Alert
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Fracture Coding
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Reader Question:
Impairment Rating
Question: What code should I use when the physician does an impairment rating?
Colorado Subscriber
Answer: [...] - Reader Question:
Component of THR
Question: An orthopedic surgeon performs a revision of the acetabular component of a total hip [...] - Reader Question:
Co-Surgeons
Question: One surgeon from our practice performed an open reduction with internal fixation of a [...] - Reader Question:
Arthroscopy Coding
Question: The operative report lists chondroplasty of the humeral head chondral fracture and removal of [...] - Reader Question:
Nerve Conduction Studies in Office
Question: We've started to perform nerve conduction studies (NCS) in our office. The equipment vendor [...] - Reader Question:
Return to the OR
Question: What diagnostic code do I use for the loss of reduction or fixation on [...] - Reader Question:
Pain Pump
Question: I have been using 37202 (transcatheter therapy, infusion other than for thrombolysis, any type [...] - Reader Question:
Marcaine Payment
Question: I am having difficulty getting paid for Marcaine. We use the unlisted HCPCS code [...] - Reader Question:
Billing for a Medicare Patient
Question: Should 20936 and 20937 be billed together with modifier -59? This is a Medicare [...] - Reader Question:
Closed Reduction for Multiple Fracture
Question: The physician performed a closed reduction of a fracture of both bones and a [...] - Reader Question:
Radiofrequency
Question: My physician performed an arthroscopic radiofrequency thermal debriding of unstable articular cartilage in all [...] - Reader Question:
Carpal Scaphoid
Question: My surgeon is performing a 25628 (open treatment of carpal scaphoid [navicular] fracture; with [...] - Reader Question:
Open Reduction
Question: My surgeon spent 10 to 15 minutes on a patient, attempting a closed reduction [...]
