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Orthopedic Coding Alert

Reader Questions:

Include Synovial Crystal Identification in Surgery

Published on Sun May 28, 2006

Question: Our surgeon uses polarization to identify crystals during total joint replacements. Often, he makes a wet smear at the time of the gross examination. Which code can we report for this service? Our office manager suggested 89060, but this refers to -any body fluid, except  urine,- and the substance our surgeon is examining doesn't qualify as a fluid.

Michigan Subscriber Answer: Unfortunately, you cannot report any additional codes for the surgeon's work obtaining the specimen if he collects it during the patient's total joint replacement surgery. Insurers consider the wet smear incidental to the surgery and therefore will not reimburse you separately for the service.
 
Instead, you should report just the appropriate joint replacement code, such as 27130 (Arthroplasty, acetabular and proximal femoral prosthetic replacement [total hip arthroplasty], with or without autograft or allograft).
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