Wiki temporary hemiepiphysiodesis help!!!

Carrie.Barse@sanfordhealth.org

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I am starting to make myself confused about how i should be billing this procedure. 27485-52, should I be using an unlisted code?


Using fluoroscopic guidance, a 5-cm long longitudinal incision was made
on the medial knee, centered over the distal femoral physis. The
incision was carried sharply through skin and subcutaneous tissue. The
deep fascia was divided longitudinally. Vastus medialis was reflected
slightly anteriorly. A Keith needle was placed in the physis with
position confirmed with intraoperative fluoroscopy. A 20-mm-length
Ortho pediatrics 8-plate was selected and slid over the Keith needle.
In this way, it was straddling the physis. Guidewires were drilled
into the metaphysis and epiphysis under fluoroscopic guidance. The
wires were overdrilled. A 24-mm length cannulated screws were placed
over the guidewires into the metaphysis and epiphysis. Both screws had
good purchase in bone. Final fluoroscopic images demonstrated
satisfactory plate position, screw length and screw position.

The wound was thoroughly irrigated with normal saline. Deep fascia was
returned with running 2-0 Polysorb suture, subcutaneous layer with
interrupted 2-0 Polysorb suture, and skin with 4-0 Biosyn in a running
subcuticular fashion. Benzoin and Steri-Strips were applied. Wound
site was infiltrated with 10 mL of 0.5% Marcaine for postoperative
pain relief. Sterile dressings were applied.
 
Insurance is SD Medicaid. The reason I am thinking a 52 is b/c he doesnt do an osteotomy and remove any bone and he also doesnt remove the growth plate, which is what the description in my coding companion states.
 
Why are you using modifier 52 for reduced services?
Who are you billing, Medicare, Medicaid, Managed Care?

Insurance is SD Medicaid. The reason I am thinking a 52 is b/c he doesnt do an osteotomy and remove any bone and he also doesnt remove the growth plate, which is what the description in my coding companion states.
 
I am having the same issue, the doctor is wanting to bill 27485 when I do not feel it is the right code, he also is performing this procedures as outpatient and 27485 is inpatient only. Did you ever figure out the correct code to bill?
 
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