Help!! I'm not sure what is the correct way to code this.
Diagnosis: Nonunion left subtrochanteric femur fracture
Procedure: Exchange gamma nailing using a 340 mm 13 mm diameter gamma nail with a same sixe screw as previous with a 90 mm lag screw all in the femur.
Technique: We made an incision proximal hip in line with her previous insertion site. We took that down through subcu tissue and abductors until the greater trochanter was identified. The nail was palpable at the tip of the great trochanter and the central portion of the nail was then curetted of soft tissue. The set screw was then removed and the insertion guide was placed on the tip of the nail proximally. We then made an incision laterally were able to localize the lag screw and curette that threads the tip of that. We inserted a screwdriver and were able to remove the lag screw with out difficulty, Once that was removed we backslapped the nail and removed it. A ball tipped guidewire was then place on the medullary canal and its position verified radiogaphically. We then began reaming . Once we had good chatter and felt that we could no longer place a larger nail a 13 mm in diameter nail was placed over the ball tipped guidewire and seated. the guidewire was then removed. a lag screw was place. wounds were irrigated.
Would I only code out 27245. The hardware removal would be included with this correct? or do you code this as a nonunion repair 27470?
Any suggestions?
Thanks in advance!
Diagnosis: Nonunion left subtrochanteric femur fracture
Procedure: Exchange gamma nailing using a 340 mm 13 mm diameter gamma nail with a same sixe screw as previous with a 90 mm lag screw all in the femur.
Technique: We made an incision proximal hip in line with her previous insertion site. We took that down through subcu tissue and abductors until the greater trochanter was identified. The nail was palpable at the tip of the great trochanter and the central portion of the nail was then curetted of soft tissue. The set screw was then removed and the insertion guide was placed on the tip of the nail proximally. We then made an incision laterally were able to localize the lag screw and curette that threads the tip of that. We inserted a screwdriver and were able to remove the lag screw with out difficulty, Once that was removed we backslapped the nail and removed it. A ball tipped guidewire was then place on the medullary canal and its position verified radiogaphically. We then began reaming . Once we had good chatter and felt that we could no longer place a larger nail a 13 mm in diameter nail was placed over the ball tipped guidewire and seated. the guidewire was then removed. a lag screw was place. wounds were irrigated.
Would I only code out 27245. The hardware removal would be included with this correct? or do you code this as a nonunion repair 27470?
Any suggestions?
Thanks in advance!