Orthopedic Coding Alert
CCI Allows 23470 + 23332 + Bone Graft
Question: The orthopedic surgeon performed a revision hemiarthroplasty and removed the components of a shoulder arthroplasty. He also completed autologous bone grafting to the glenoid and an allograft patch to augment the subscapularis. Can I report each of these procedures individually? Kentucky Subscriber Answer: You can submit several codes on your claim because Correct Coding Initiative (CCI) edits do not list any bundling issues. You should report the following: • 23470 (Arthroplasty; glenohumeral joint; hemiarthroplasty) for the revision • 23332 (Removal of foreign body, shoulder; complicated [e.g., total shoulder]) for the previous arthroplasty components removal • 20900 (Bone graft, any donor area; minor or small [e.g., dowel or button]) or 20902 (... major or large) for the bone graft, depending on how much bone the surgeon used. Add 22: The allograft patch is not separately billable. You can, however, append modifier 22 (Increased procedural services) to 23470 for the additional work and ask for a 20-percent fee increase for 23470. Be sure your surgeon has notes in the original report or dictates an addendum describing the additional work to help justify reporting modifier 22.
Orthopedic Coding Alert
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CCI Allows 23470 + 23332 + Bone Graft
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