clark.amy86
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Good morning,
I have a coding question regarding operative fixation of a medial femoral condyle and/or medial tibial plateau insufficiency fracture(s) via injectable calcium phosphate cement with fluoroscopic and/or arthroscopic aid. I have attached a copy of a scrubbed operative report and the " Zimmer Biomet Subchondroplasty Coding Reference Guide” for your reference.
Our practice has been unable to obtain payment for: operative fixation of a medial femoral condyle and/or medial tibial plateau insufficiency fracture(s) via injectable calcium phosphate cement with fluoroscopic and/or arthroscopic aid; we typically bill 27599 and compare it to 29855 or 29856.
We currently have multiple doctors repairing insufficiency fractures via this method and the patients mainly have BCBS for their insurance. The procedures are being denied as “experimental” by insurance after submitting the operative report and unlisted procedure letter to justify our billing. There is quite simply not much information out there when researching this surgical method, so I was hoping to get your input. What would be the proper way to bill this procedure?
I have a coding question regarding operative fixation of a medial femoral condyle and/or medial tibial plateau insufficiency fracture(s) via injectable calcium phosphate cement with fluoroscopic and/or arthroscopic aid. I have attached a copy of a scrubbed operative report and the " Zimmer Biomet Subchondroplasty Coding Reference Guide” for your reference.
Our practice has been unable to obtain payment for: operative fixation of a medial femoral condyle and/or medial tibial plateau insufficiency fracture(s) via injectable calcium phosphate cement with fluoroscopic and/or arthroscopic aid; we typically bill 27599 and compare it to 29855 or 29856.
We currently have multiple doctors repairing insufficiency fractures via this method and the patients mainly have BCBS for their insurance. The procedures are being denied as “experimental” by insurance after submitting the operative report and unlisted procedure letter to justify our billing. There is quite simply not much information out there when researching this surgical method, so I was hoping to get your input. What would be the proper way to bill this procedure?