Wiki Coding-Total Hip Revision

[mcduffiegal]

We are having a real problem with Humana paying a revision of a hip. I have submitted 27137 and was denied. I looked it up on the internet and some coders said to use 27134 w/ 52 mod. I tried that and was denied again. Any help would be greatly appreciated. Here is the dictation.

 

[fltbaroque]

This sounds more like exchange of acetabular liner w/ revision of femoral head.
per AAOS bulletin, use 27134-52

http://www2.aaos.org/bulletin/oct05/coding.asp

The problem with Humana is that if the code wasn't pre-authorized, they aren't likely to pay. You may have to do a peer to peer review, if they still do that.