Wiki Revision ORIF

[broncsrox]

Patient is about 2 years status post ORIF for intertrochanteric fracture. For some unknown reason (patient did not fall or have any other type injury) the plate came loose and lodged in his pelvis. The doc retrieved and removed the plate then put a new, shorter plate in. I am thinking I should code 27244 but I'm not sure about any modifiers as the patient is well outside the global period. I don't feel either 22 or 52 is appropriate based on his documentation.

My other concern is Medicare paying for that code with a primary dx of 996.40.

Any thoughts?

Thanks!

 

[jdemar]

I think your Dr. should do an addendum and be more specific, because a revision is much more involved than a fresh ORIF, with scarring, healing, etc....I then I would use the -22 modifier with the CPT you noted. Also, I would use 996.78, because I do not believe a loose plate is a mechanical complication.