orthopaedics

  1. S

    1 stage exchange - Total Hip Revision, complicated

    Hello! I work at an orthopedic group and this is the first time I'm hearing of this. I will insert the doctor's description of the surgery farther down, but essentially they do a 2-stage revision for an infected THA in 1-stage. It's a seemingly very new procedure, and my coding manager and I are...
  2. J

    Question Global billing and ER visit

    Patient is in global for hip fx goes to ER for anemia and next day has a consult by another provider in the ortho office for hip and thigh pain. Would it still fall into post op?
  3. K

    Intrinsic release of the index middle ring and small finger/opponens pollicis release

    I am not 100% sure on how I should code this, but I am thinking 26593x4 and 26440 for the opponens release. Any advice is appreciated! POSTOPERATIVE DIAGNOSIS(ES): Volkman's contracture of the left hand PROCEDURE: Intrinsic release of the index middle ring and small finger and release of the...
  4. A

    Question Documentation for Arthrocentesis and Injections

    I am trying to find a break down of the required elements of documenting arthrocentesis/injection. Clarification on what I am looking for to ensure the injection is documented correctly. Something I can use to show providers what is missing. I have the gist, but having a detailed break down...
  5. J

    Question Coding/Billing for implants HCPCS

    Recently took over billing for implants for ASC Ortho. They were submitting all implants under L8699 and a lot are getting denied. Should they be submitted with more specific C codes per each supply instead of the L8699? Ex: Guidewire is C1769
  6. K

    Hemi shoulder conversion

    How would you code this since there is no conversion shoulder cpt? Since it has been years since her hemi would you code a total shoulder or revision? I included a note from the last office visit plus the op note. This is from the office visit -This is a DePuy hemi. We talked about possible...
  7. D

    Question Pilon vs Trimalleolar Fx

    Good morning! I need some help in deciding if this is a Pilon Fx-27828- and ankle dislocation with IF-27848- (per what the doctor is requesting) or if this should be coded as a trimalleolar ORIF. I've gone back and forth with this any help or advice will be appreciate....below is the OP note...
  8. D

    Closed Treatment Internal Fixation w/ Fibular IM Nailing

    Can someone point me in the right direction with which CPT code to use for this? Patient had a right distal fibula closed reduction and internal fixation with fibular IM nailing. The only thing I can come up with relatively close is 27759 but that is for the tibia. Below is a portion of the OP...
  9. D

    I have a question regarding EMG billing

    My facility has an electromyographer (EMG tech) come to our office twice a week to perform EMGs. We have been billing the EMGs under the referring doctor. Most of the time that referring doctor is in the buildling at the time that the EMG is performed and this is billed as incident-to...
  10. K

    TFN Blade Shortening Procedure?

    How would you code this? Any guidance appreciated! PRE-OP DIAGNOSIS: Painful hardware left hip HPI: Had a left gamma nail placed. The fracture healed with compression and the screw slid laterally. This became painful. She has a hard time laying on that side and has pain with walking...
  11. S

    excision of palmaris profundus tendon...help!

    Hi, I am hoping someone can help me with my coding dilemma...during a typical Carpal Tunnel release the surgeon noted that there was an accessory tendon draped over the median nerve and defined it as a the palmaris profundus tendon. He excised this tendon. I am hoping someone can help me...
  12. K

    Please help! Tendon ruptures repair with carpal tunnel release

    I need help coding the following: I don't know if I should code 64721,26440 and 26415, one or the other or what quantity. Right carpal tunnel release, exploration flexor tendons in right palm, side to side repair FDP ring finger to FDP long finger, end to side repair FDP right small finger...
  13. M

    Loose bodies not in Knee Joint

    I hope someone will be able to help me. Lately surgeon's are documenting: "There were diffuse grade 2/3 articular cartilage changes from the medial femoral condyle. There was a radial tear involving the posterior horn and the medial meniscus near the root attachment along the medial aspect of...
  14. D

    Medial Parapatellar arthrotomy help!

    Can anyone help me with coding for this surgery? I'm very stuck and the codes the doctor wrote down do not seem to match what was actually done. Thank you in advance! PREOPERATIVE DIAGNOSIS: Left knee patella chondral defects secondary to patella subluxation episode. POSTOPERATIVE DIAGNOSIS...
  15. D

    Help with arthroscopic stress fracture coding!

    Our doctor often performs stress fracture repairs using Knee Creations calcium phosphate cement and I have trouble with coding this. In this case, it seems he is doing it arthroscopically or percutaneously, and he likes to try to code it as 27509. I'm not sure I feel this is the appropriate...
  16. J

    aponeurotomies help

    Hello! 1st time posting! Trying to utilize my resources. Operative report reads: PROCEDURE: Multiple incisional epineurotomies and excision of Dupuytren's tissue right ring, index, first web space and long finger. Attention was turned to the palm, where all identifiable Dupuytren's tissue was...
  17. J

    Knee surgery

    Our physician performed an open repair of IT Band avulsion. Any ideas on the CPT code to use??
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