Wiki Help with 27245

[FREEPONY]

My physician needs to go in to revise the original procedure 27245. He is not taking out the implant but revising the nail placement and position. How would you code this. I can't seem to find a cpt code for this. I thought of using the original procedure but using the modifier 52 for reduced services. This is a Medicare patient.

 

[PatriciaCPC]

I would assume changing the position of the nail, but still using the same nail... the surgeon would have to remove it, drill again, and re-implant it. I would use the unlisted 27299 - cross-referencing the 27245.
(if it is during the post op period, don't forget the 78 modifier).

However if your surgeon is using a new nail, I would code the removal of the implant 20680 and the implant procedure 27245.
Even though the procedures sometimes change once a patient is on the operating table, your surgeon should know best what he 'plans' for the pt. Ask them to be more specific... it may guide you better. Have a good weekend!

 

[mbort]

you may also want to see 27033 for the removal/revision of the foreign body (ie:hardware) since this is deeper in the joint and not easily accessable through soft tissue alone. The dx crosscoder allows for complications of orthopedic implant issues.