27358 vs 27495

kankrom

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27358 is add on code for CPT 27357- it is for internal fixation in addition to bone tumor excision. He wants to bill 27495 for the fixation he did in addition to the 27357. What is the difference between 27358 and 27495 other than huge difference in RVUs??
 

CodingKing

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One is done on its own and one is done in conjunction with excision of bone. The stabilization is being done because the bone pieces are being removed so its not a prophylactic treatment. The RVU us lower for the add-on code because most of the work is included in the primary code. The main reason you should be billing 27358 is because that's what the AMA/CPT guidelines state to use.

AMA Guidelines:(Use 27358 in conjunction with 27355, 27356, or 27357)
 
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