Wiki OR Return bundling 27506

[ksobota]

Looking for an opinion on billing an ortho surgery.

27506:Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws

Physician performed this initial surgery WITHOUT the locking screw placement. This was done intentionally, as it didn't seem as though it would be necessary for the patient intraoperatively.

A few days later, instability in the fracture was noted and they went back in and placed the locking screws.

Would this secondary procedure (the locking screw placement) be bundled within the original surgery as it is normally an optional component of the original procedure?
TYIA for any input!

 

[NRaizman]

This would not be bundled.
Complications treated intraoperatively during a single session are bundled. That's not the case here.

This would be considered an unplanned return to OR during the global. Modifier 78 on the second surgery.

 

[ksobota]

This would not be bundled.
Complications treated intraoperatively during a single session are bundled. That's not the case here.

This would be considered an unplanned return to OR during the global. Modifier 78 on the second surgery.

Thank you so much for the input!