New Coder needs HELP

lovewdisney1

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The patient fell in November 2010 and had a fx hip with ORIF, coded 27236 and 82009. The patient went home and one month later during the post op period, he fell again. The same doctor saw this patient again with a diagnosis of periprosthetic hip fracture, and performed an ORIF with hip hemiarthroplasty, revision.

Should I code this 27236 (Open treatment of femoral fx, proximal end, neck, internal fixation or prosthetic replacement)? Or is there a code that would fit this better.

Also, should this have a 78 modifier ( unplanned return to the operating room by same physician during post op period) or 79 (unrelated procedure by same physician during the postop period)? This was the same area but different fall.

Thanks for your help.
 
The patient fell in November 2010 and had a fx hip with ORIF, coded 27236 and 82009. The patient went home and one month later during the post op period, he fell again. The same doctor saw this patient again with a diagnosis of periprosthetic hip fracture, and performed an ORIF with hip hemiarthroplasty, revision.

Should I code this 27236 (Open treatment of femoral fx, proximal end, neck, internal fixation or prosthetic replacement)? Or is there a code that would fit this better.

Also, should this have a 78 modifier ( unplanned return to the operating room by same physician during post op period) or 79 (unrelated procedure by same physician during the postop period)? This was the same area but different fall.

Thanks for your help.

Yes, I would use 27236-79, since it's not a complication to the original sx but a new, unrelated injury.
Jenna
 
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