nyyankees
True Blue
I need a little help here. My Dr has been seeing patients (very few) that have a prior ACL surgery that needs to be revised. What he has been doing is doing a surgery as follows:
29881 - menisectomy
20680 - removal of hardware
20902 - bone graft
27310 - debridement
What he does is fix the meniscus tear (29881) and while he's there he'll take out the screw (20680) and start drilling and tunneling for a furture ACL repair. He'll add some bone graft material (20902) and prep the knee (27310). When I q'd him on the 27310 (stating we should just submit 20680) he stated that he did a LOT more work than a hardware removal. Now the ins co. has denied the 27310 (surprise) and used that denial to bundle the 20680! I knew I'd have a problem with this type of "pre-ACL revision" surgery. Now my question:
What do you think would be the best way to go about getting either the 27310 and/or 20680 paid?
29881 - menisectomy
20680 - removal of hardware
20902 - bone graft
27310 - debridement
What he does is fix the meniscus tear (29881) and while he's there he'll take out the screw (20680) and start drilling and tunneling for a furture ACL repair. He'll add some bone graft material (20902) and prep the knee (27310). When I q'd him on the 27310 (stating we should just submit 20680) he stated that he did a LOT more work than a hardware removal. Now the ins co. has denied the 27310 (surprise) and used that denial to bundle the 20680! I knew I'd have a problem with this type of "pre-ACL revision" surgery. Now my question:
What do you think would be the best way to go about getting either the 27310 and/or 20680 paid?
