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Op Report

  1. #1
    Long Island/New York
    Default Op Report
    Medical Coding Books
    I have an op that I'd like an opinion on:

    Operation: In Situ Screw Fixation for Slipped Capital Femoral Epiphysis

    We placed a guide wire on the anterior aspect of the femoral neck along the intertrochanteric line. This was advanced using AP and lateral images so that it was centered in the femoral neck and in the epiphysis. We crossed the physis with it and got the pin into a few mm within the articular surface.

    We now measured the length of the embedded pin and now made an approximately one cm incision overlying the pin. We now drilled over the guide wire and placed the appropriate length fully threaded large AO cannulated screw over the guide wire.

    The hip was now put through a full range of motion under fluoroscopic guidance. The screw did not enter the hip joint at any location. It was in a good position in all respects. The guide wire was removed.

    He originally used 27176 but since he didn't use "traction" that was not a good code. Then with 27177 he states he did not do an "open" procedure. But he did make a "one cm incision". Any thoughts are appreciated. Thanks.

  2. #2
    Milwaukee WI
    Default 27176
    This is NOT my area of expertise, but ...

    The semi-colon tells us that this code does NOT include the traction. It sometimes helps if you completely write out the entire code:

    27175 Treatment of slipped femoral epiphysis; by traction, without reduction

    27176 Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ

    (Emphasis added by FTB for illustration purposes)

    F Tessa Bartels, CPC, CEMC

  3. #3
    I think 27176 would be appropriate. It does not include traction, only 27175 does. The semicolon separates the 27175 and 27176. Therefore, 27176 would really read as "treatment of slipped femoral epiphysis; by single or multiple pinning, in situ". I hope this helps.

  4. #4
    Greater Pittsburgh
    I agree with 27176.
    jdemar, CPC, CMA

  5. #5
    Long Island/New York
    Thank you all!!! I agree...will spk with my Dr

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