I don't know alot about ortho coding so if someone could help I would appreciate it.
My 81 year old mother broke her hip and had a replacement. 6 weeks later she dislocated her hip twice in a week. They decided they needed to go back in so they did surgery, removed old hardware and replaced with new longer rod. They coded 27138 which is correct and a 20680 and 26990. Insurance paid everything except the 20680 they denied because service was included in another service provided at the same time. I know a modifier needs to go on there, but not too sure which. It was about 8 weeks between 1st surgery and second surgery so it was less than 90 days. She passed away about 5 weeks later unfortunately and they are saying we owe the denied amount, which is incorrect because the office coded it wrong.
Sorry this is so long, but wanted to give all info.
thanks!
My 81 year old mother broke her hip and had a replacement. 6 weeks later she dislocated her hip twice in a week. They decided they needed to go back in so they did surgery, removed old hardware and replaced with new longer rod. They coded 27138 which is correct and a 20680 and 26990. Insurance paid everything except the 20680 they denied because service was included in another service provided at the same time. I know a modifier needs to go on there, but not too sure which. It was about 8 weeks between 1st surgery and second surgery so it was less than 90 days. She passed away about 5 weeks later unfortunately and they are saying we owe the denied amount, which is incorrect because the office coded it wrong.
Sorry this is so long, but wanted to give all info.
thanks!