Orthopedic Coding Alert
Medicare Bundles DVT Evaluations
Question: Five days after I performed a total hip replacement, I evaluated the patient in the rehabilitation unit and diagnosed deep vein thrombosis (DVT). Can I bill separately for this evaluation, or is it considered a complication of the hip replacement surgery?
Tennessee Subscriber
Answer: Because DVT is a recognized complication of total hip replacement surgery (27130, Arthroplasty, acetabular and proximal femoral prosthetic replacement [total hip arthroplasty], with or without autograft or allograft) your evaluation is not a billable service according to the Medicare global surgery guidelines.
Medicare only covers services related to postoperative complications if you must return to the operating room. If your patient requires care in the OR, you should append modifier -78 (Return to the operating room for a related procedure during the postoperative period) to the DVT-related surgical code.
Orthopedic Coding Alert
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