Wiki Re-amputation

[MichelleWerwinski]

Pt. had a BKA, than a knee disarticulation and now presents for a AKA all on the same leg. Do I use the re-amputation or the AKA 27590 with a
79 modifier for furthering of disease? I billed for the BKA (27880-27888), then the 27598 for Knee Disarticulation.

 

[Bella Cullen]

I think 27590 but with a 58 modifier because this is related to the previous surgery.

 

[jdemar]

If all in the global I would have done 27880-RTor LT
27598-58, RT or LT
27590 -27592 58, RT or LT, the 58 modifier is for

1. Planned or anticipated (staged) OR

2. MORE EXTENSIVE THAT THE FIRST or

3. Therapy following a surgical procedure.

Depends if it's in the global, diagnosis etc....FYI

58- resets the global and 100% reimbursement is expected of allowable.
78- global stays with the orginal case, 50-70% reimbursement is expected of allowable.
79- is not for complications and MUST HAVE A DIFFERENT SX and MAKE IT THE PRIMARY DIAGNOSIS expect 100% of allwable.

 

[MichelleWerwinski]

Re-Amputation code 27596

When would this code be used?

 

[Bella Cullen]

I would use 27596 if doc has to do a re amp again after the AKA 27590-27592.
But since the first one was BKA then AKA that is why I would do it like that.

 

[jdemar]

as Bella said for the re-amputation they have to be under the primary surgery site/code and there are two re-amps....1. secondary closure or scar revision is with no bone involvement and 2. re-amputation, when more bone is taken, again under each individual code .....AKA 27590, 27594, 27596 or BKA 27880, 27884, 27886. Hope this helps.

 

[igrigoras@iowaclinic.com]

If a patient has a guillotine amputation (27882) of the lower extremity, would it be appropriate to use 27880/58 few days later for below knee amputation?