Help with COMPLEX Hardware Removal Modifier 22

Pillow1

Guru
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124
Location
Rockledge, FL
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Any way to bill for extensive complex hardware removal? Would use these codes, but looking to expand upon them.
Thanks for any help.

27130
27134
20680

Pre op Diagnoses::
1. Malunion, nonunion, left proximal intertrochanteric hip fracture.
2. Limb length inequality, left leg.

Post op Diagnoses:
1. Malunion, nonunion, left proximal intertrochanteric hip fracture.
2. Limb length inequality, left leg.
3. Degenerative labral tearing of left hip.

Names of Procedures:
1. Restoration Modular press-fit left total hip arthroplasty.
2. Deep complex hardware removal of cephalomedullary nail.
3. Intraoperative fluoroscopy.

Surgeon
and
Assistant Surgeon

This case took approximately 4 hours, which is still longer than a revision total hip. Almost three times longer than a standard primary total hip arthroplasty, considering we had a complex hardware removal taking an hour and a half, just to get the bone ingrowth, around the gamma nail removed and then recanalizing the femoral shaft, due to the previous gamma nail deformity placed inside the endosteal canal of the femur, requiring significant amount of fluoroscopy and radiation exposure to facilitate stem passage, past the potential fracture site of the gamma nail.

4 page op note....

Thanks for any feedback!
 
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