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Orthopedic Coding Alert

READER QUESTIONS:

Carrier Can Secure How You Use S-Codes

Published on Sat Aug 01, 2009

Question: We have been billing out 27299 for total hip resurfacing but then Regence requested we use S2118 instead. A coworker said that we are supposed to use the new S2118 with 27299. But that doesn't really make any sense. It seems like it would be one or the other. Why would we use both? Utah Subscriber Answer: Call your carrier, as that does not sound right. Blue Cross Blue Shield (BCBS) almost always accepts S-codes, such as S2118 (Metal-on-metal total hip resurfacing, including acetabular and femoral components), but you should check the payer's policy regarding S2118. If the payer accepts this code, then that usually means the payer accepts it without the addition of an unlisted code. Remember: S-codes are private payer codes.Medicare, Medicare, Tricare, CHAMPUS, or CHAMPVA never cover them. If your Regence payer does not accept S2118, it still may want you to use unlisted code 27299 [...]
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