Wiki ORIF periprosthetic tibial fracture

[RebeccaMoney]

I billed the enclosed surgery with CPT 27758 (ORIF tibial shaft fracture). Would someone be willing to look at this and tell me what CPT they think. Insurance is saying that 27758 is not documented.
Thank you,

 

[cclarson]

They might be wanting 27759 for the intermedullary implant. I looked online and learned that the rod that was used counts as an intramedullary implant. I feel like 27758 would also work just fine to describe the procedure and the op note is thorough. I would talk with the doctor to confirm which code better suits what was done. If you choose to stay with 27758, then appeal and underline the description of the procedure within the op note. I hope this helps!

Tibiotalocalcaneal Fusion (with Intramedullary Rod) - TCC Fusion Rod​

 

[RebeccaMoney]

They might be wanting 27759 for the intermedullary implant. I looked online and learned that the rod that was used counts as an intramedullary implant. I feel like 27758 would also work just fine to describe the procedure and the op note is thorough. I would talk with the doctor to confirm which code better suits what was done. If you choose to stay with 27758, then appeal and underline the description of the procedure within the op note. I hope this helps!

Tibiotalocalcaneal Fusion (with Intramedullary Rod) - TCC Fusion Rod​

Yes, thank you