Orthopedic Coding Alert
READER QUESTION:
Don't Avoid Unlisted
Published on Thu Feb 08, 2007
Question: Our surgeon documented a repair of the gluteus medius tendon to treat a tear in the tendon. Which CPT code should we report for this service?
Oklahoma Subscriber
Answer: Because CPT does not include a specific code for this service, you should report the unlisted-procedure code 27299 (Unlisted procedure, pelvis or hip joint).
You should include your documentation with the claim. In addition, your surgeon should write a letter comparing this procedure to a similar surgery (for example, 27385, Suture of quadriceps or hamstring muscle rupture; primary) and explaining why he thinks he should be able to collect reimbursement applicable to what the insurer pays for the -compare- code.
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