Orthopedic Coding Alert

Question: A patient who underwent ulnar osteotomy came in for an injection of AmnioMatrix into the fracture site for delayed union. How can we report this?

New York Subscriber

Answer: The initial procedure that your patient has undergone is an ulnar osteotomy, 25360 (Osteotomy; ulna) which has a global period of 90 days. If the injection was provided by a provider other than the one who did the initial ulnar osteotomy, no global period applies. If the provider who had performed the main surgery is also providing the injection and the underlying diagnosed condition is the same and within the global period, then you cannot separately code for this service.

There isn’t a specific code for the injection, so an unlisted procedure code is the best. If you are billing for Medicare and if injection was given at hospital outpatient, you also report the product code V2790 (Amniotic membrane for surgical reconstruction, per procedure) for AminoMatrix. AminoMatrix is non-steroidal, anti-inflammatory injection derived from amniotic tissues that are cryo preserved and this serves as a liquid human allograft. AminoMatrix may be delivered to the fracture site by using a needle under imaging guidance with ultrasound or other modality.