Wiki revision arthroplasty

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ania.dymora@gmail.com

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our surgeon performed shoulder arthroplasty and postoperatively, during transfer off the bed, a shift was appreciated. Postoperative x-ray did show that the humeral hardware was protruding through the lateral cortex. Decision was made to revise the humeral component and that happened the same day, within few hrs from the original sx. I coded 23472 for initial sx and 23473 with 78 mdf for revision of humeral component only. Not sure if this is correct. Any help is greatly appreciated. Thank you
 
Do you feel what you described meets the definition of 78?
Modifier 78 is used to report an unplanned return to the operating or procedure room, by the same physician, following an initial procedure for a related procedure during the post-operative period.

In this case, it appears it wasn't planned or staged (58).
This appears to be an unplanned return.
It's definitely not a 79.

 
Thank you soo much for responding to my question. I am confident with using 78 mdf, i quess my question was whether or not 23473 cpt code was appropriate considering it was done within few hrs from initial sx. Is there a time frame in this kind of scenario?, it's my first time coding this kind of sx and i can't find any documentation on it...Thank you
 
Oh, I see, I thought you were asking about the modifier. Yes, as long as the description of the procedure was met. Did they take the first humeral component out and replace it with a new one? Or did they just go in and reposition it? it would be correct despite the fact that it happened the same day. I have seen this before with other prosthesis, sometimes it's the following day.
 
Good point! If they take them back in on the same calendar day. I feel that when I have done these and they took them back in the same day I only used a 78 and it was okay. It is possible it could be payer dependent. There is a NCCI edit (of course) for 23473 & 23472. So agree, it may take XE or 59 and the 78 together.
 
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