Orthopedic Coding Alert

Question: The orthopedic surgeon performed a revision hemiarthroplasty and removed the components of a shoulder arthroplasty. He also completed autologous bone grafting to the glenoid and an allograft patch to augment the subscapularis. Can I report each of these procedures individually?Kentucky SubscriberAnswer: You can submit several codes on your claim because Correct Coding Initiative (CCI) edits do not list any bundling issues. You should report the following:• 23470 (Arthroplasty; glenohumeral joint; hemiarthroplasty) for the revision• 23332 (Removal of foreign body, shoulder; complicated [e.g., total shoulder]) for the previous arthroplasty components removal• 20900 (Bone graft, any donor area; minor or small [e.g., dowel or button]) or 20902 (... major or large) for the bone graft, depending on how much bone the surgeon used.Add 22: The allograft patch is not separately billable. You can, however, append modifier 22 (Increased procedural services) to 23470 for the additional work and ask for a 20-percent [...]