Wiki Total hip AND revision in one setting

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madgejones10

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This is a real doozey! Pt. went in for total hip replacement. This was done, but in rotating the hip, it was unstable at the conclusion of the surgery. My ortho decided to revise to a larger cup size, new liner and new ball. How would you code this? 27130 and then 27137 with a "58" modifier or would you just code for a total revision 27134 ? I am SO CONFUSED!
 
You're right.......this is a doozey!! I wouldn't use modifier 58 for the revision since that's for a staged procedure. The CPT book I have says for tx of a problem that requires a return to the OR (eg, unanticipated clinical condition) use modifier 78. BUT, since it's done on the same day, not sure how that would pay out and if it's acceptable. Possibly 100% on the revision and then the 50% on the 27130...............??? Ultimately you may only get paid for the revision.
 
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