Wiki Cement removal for hemiarthroplasty

[hrstone]

Hi all, I need help coding a complicated hemiarthroplasty. Apparently while adding the cement it became hard. The Doctor only filled the 3/4 of the canal, because of the inadequate cement volume, he had to remove the cement. The procedure should have taken an hour and a half, but took a total of 5 hours. My Doctor feels adding a modifier 22 to CPT 27236 is not sufficient for the total time and complexity of the procedure. New cement was brought in and the procedure was successfully completed, but how can I code the removal of cement and complexity?

 

[OCD_coder]

Unfortunately for your surgeon, there isn't a "Code" to capture that work. It's just part of doing business and comes with the territory and it's not entirely fair.

This is a great example of a situation where mod-22 would be supported as long as he includes the right information. I suggest to my surgeons first, make an independent paragraph documenting the work that is explictly over and above the scheduled portion of the surgery. Second, give a time ratio; normal time as to compared with the extended time. We aren't needing pages of description; use quality over quantity as they say.

We double our fee on the claim, eventhough they will probably only pay 20% above the contracted rate. And see what they pay. Sometimes we get the whole fee, sometimes we only get an additional 20%.