cmort68
Contributor
Good Morning!!
I need assistance about this scenario I have encountered and I need guidance. A provider of mine had a patient that dislocated her Total Hip Arthroplasty, presented to the ER and the Dr's in the ER could not reduce successfully. Contacted my provider who presented to the ER and could not relocate the hip. My provider then took the patient to the OR under anesthesia attempted another reduction, which failed and this point, my provider, determined he would need to do a Revision THA the next day. I have run this scenario by my Practice Administrator and we know that we can't bill the attempted reduction in the ER. But, our question is this.....We can code the CPT for the attempted reduction in the OR but modifiers are needed, obviously, along with the revision THA the following day. So, here's what I think should be coded......27266-53-RT (failed reduction in the OR) and then 27134 (both components) -58-RT....I feel like I am missing a modifier. Any thoughts, suggestions??? This is another encounter that I have not dealt with in my 2 years of coding Ortho....and I feel stumped, but on the bright side, I am learning something new
I need assistance about this scenario I have encountered and I need guidance. A provider of mine had a patient that dislocated her Total Hip Arthroplasty, presented to the ER and the Dr's in the ER could not reduce successfully. Contacted my provider who presented to the ER and could not relocate the hip. My provider then took the patient to the OR under anesthesia attempted another reduction, which failed and this point, my provider, determined he would need to do a Revision THA the next day. I have run this scenario by my Practice Administrator and we know that we can't bill the attempted reduction in the ER. But, our question is this.....We can code the CPT for the attempted reduction in the OR but modifiers are needed, obviously, along with the revision THA the following day. So, here's what I think should be coded......27266-53-RT (failed reduction in the OR) and then 27134 (both components) -58-RT....I feel like I am missing a modifier. Any thoughts, suggestions??? This is another encounter that I have not dealt with in my 2 years of coding Ortho....and I feel stumped, but on the bright side, I am learning something new