Wiki 27228 with 27130

[JYSPA]

Patient has posterior column, posterior wall and femoral head fractures. Physician does ORIF for acetabular fractures and total hip replacement for femoral head fracture. Can I bill both CPT 27228 and 27130? They bundle but I feel it is a lot of work if only one of the code is billed.

 

[degraffak]

I'm having the same issue the provider has stated the acetabular fracture was complex and documentation supports this. However he billed for a total hip replacement. CPT codes 27228 and 27130. 27228 is significantly more money but there is a CCI edit. I was advised the appeal these but I was looking for supporting information I just not able to find supporting evidence of billing both together.

 

[dav5496]

https://www.aapc.com/codes/coding-n...know-what-services-are-bundled-109374-article

Found this article from AAPC with a reference to this situation. In the article it states:

Management of acetabular fractures is bundled with 27130. Use caution when reporting acetabular fractures, since the standard operative management of the fractures may not necessitate an additional code. However, if you read in the operative note that your surgeon used hardware, you report one of the following codes:

27226 open treatment of posterior or anterior acetabular wall fracture, with internal fixation

27227 open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation

27228 open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation.