madgejones10
Guest
Need help with coding/billing for an intraoperative calcar fracture during a total hip replacement.
This turned into a 5-1/2 hour surgery. I am not at all sure how to bill this. Can anyone help?
Do I just bill the 27130 (perhaps with a 22 modifier, which really will not pay any extra) or can I add the calcar fracture???
PLEASE HELP !!!!
"... the hip was dislocated. Femoral neck cutting guide was placed and the femoral head was removed. The piriformis fossa was identified. The initiator, canal finder, box osteome and broaches up to a size 3 were used. The calcar reamer was used to ream the calcar. A medial calcar fracture, which was a 2B fractyure, was noted. At that point, with difficulty, two proximal cables were placed around the fracture and the broach. The broach was then removed. The leg ws brought back up on the operating table. A retractor was placed about the acetabulum. Progressively larger reamers up to a 49 mm reamer were used. A 50 mm porous coated acetabular component was then packed in 45 degrees of abduction, 20 degrees of anteversion. Bone slurry was placed on the floor of the acetabulum. Three screws were placed along with an Apex hole eliminator and polyethylene liner. When the leg was brought back and when the femoral neck was brought back up to the table, the fracture had shifted, Because of that, I felt it was less stable. In initially it was felt that possibly a cemented Summit stem would be appropriate but because of the size of the fracture, it was not felt to be best. At that point, I elected to put an AML stem in......."
This turned into a 5-1/2 hour surgery. I am not at all sure how to bill this. Can anyone help?
Do I just bill the 27130 (perhaps with a 22 modifier, which really will not pay any extra) or can I add the calcar fracture???
PLEASE HELP !!!!
"... the hip was dislocated. Femoral neck cutting guide was placed and the femoral head was removed. The piriformis fossa was identified. The initiator, canal finder, box osteome and broaches up to a size 3 were used. The calcar reamer was used to ream the calcar. A medial calcar fracture, which was a 2B fractyure, was noted. At that point, with difficulty, two proximal cables were placed around the fracture and the broach. The broach was then removed. The leg ws brought back up on the operating table. A retractor was placed about the acetabulum. Progressively larger reamers up to a 49 mm reamer were used. A 50 mm porous coated acetabular component was then packed in 45 degrees of abduction, 20 degrees of anteversion. Bone slurry was placed on the floor of the acetabulum. Three screws were placed along with an Apex hole eliminator and polyethylene liner. When the leg was brought back and when the femoral neck was brought back up to the table, the fracture had shifted, Because of that, I felt it was less stable. In initially it was felt that possibly a cemented Summit stem would be appropriate but because of the size of the fracture, it was not felt to be best. At that point, I elected to put an AML stem in......."
