Wiki Nonunion LT Femur repaired from graft RT

terribo

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I have a provider that is repairing a nonunion of a left femur. He is repairing the left femur using A cancellous autograft from the right femur. However, due to poor bone quality of the right femur and to prevent a subsequent right femur fracture after obtaining the graft, he choose to stabilized the right femur with an IM nail fixation.

The provider is charging code 27472 for Repair of a nonunion of the left femur with autogenous bone graft (which includes obtaining the graft). He is also billing code 27506 for treatment of the femoral shaft fracture with insertion of intrameduullary implant.

He does describe both procedures in great detail for the left femur code 27472 and the right femur code 27506.

However, I am not sure of the billing of code 27506 or if we should increase the chg of 27472 and append a modifier 22. Maybe I am overthinking this, but I think something is not quiet right.

Can anyone give me some insight?

Thank you
 
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