Wiki Revision Hip Replacement/Femur Fracture

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cwilson3333

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Pre-op Dx:
Periprosthetic right femur fracture
Total Hip Replacement 4 months prior
With Shortening Right Lower Extremity

Procedure:
1. Revision of Right Femoral Stem to Restoration Modular Stem
2. Extended trochanteric osteotomy for implant removal

Questions re coding:
1. CPT 27138 for revision femoral stem

Implant removal took 1 hour to disimpact, so extended trochanteric osteotomy done.
Cables placed around femoral stem to protect against further fracture
Do I charge for "fracture tx" and what CPT or do I modify 27138 with "22" for
the additional work?

Need some direction on correct coding.

Thanks,

CW
 
In my experience, the insurances will most likely not pay for both
27138 and an Osteotomy as well (although they are not bundled)

I would be more inclined to bill the 27138 with a -22 modifier and as long as the documentation shows the surgeon spent an excessive amount of time to accomplish the revision and it warrants the 22.

IMO....good luck :)
 
Hip Replacement/Hip Fracture

Thanks,

I was thinking along those lines, too. This surgery ended up being a 5-hour surgery, so I think the 22 modifier definitely should be added.

CW
 
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