We are having issues with the billing of a patient that had a total hip revision at a different facility & then came to us for post-op care. We billed 27134 w/mdfr 55. We have since learned that the other facility billed it as 27137 & 27138, w/o the modifier 54, even though they did not see the pt for post-op care.
My understanding of total hip revisions is that if the doctor replaces both complete components, then the correct code would be 27134 rather than 27137 & 27138, which would be considered unbundling.
I'm not sure how to address this or if we have any recourse. Any suggestions would be helpful.
My understanding of total hip revisions is that if the doctor replaces both complete components, then the correct code would be 27134 rather than 27137 & 27138, which would be considered unbundling.
I'm not sure how to address this or if we have any recourse. Any suggestions would be helpful.