Results 1 to 6 of 6

ACL Revision Pre-Surgery

  1. #1
    Location
    Long Island/New York
    Posts
    1,271
    Default ACL Revision Pre-Surgery
    Medical Coding Books
    I need a little help here. My Dr has been seeing patients (very few) that have a prior ACL surgery that needs to be revised. What he has been doing is doing a surgery as follows:
    29881 - menisectomy
    20680 - removal of hardware
    20902 - bone graft
    27310 - debridement

    What he does is fix the meniscus tear (29881) and while he's there he'll take out the screw (20680) and start drilling and tunneling for a furture ACL repair. He'll add some bone graft material (20902) and prep the knee (27310). When I q'd him on the 27310 (stating we should just submit 20680) he stated that he did a LOT more work than a hardware removal. Now the ins co. has denied the 27310 (surprise) and used that denial to bundle the 20680! I knew I'd have a problem with this type of "pre-ACL revision" surgery. Now my question:

    What do you think would be the best way to go about getting either the 27310 and/or 20680 paid?

  2. Default
    we usually bill 29888 for revision ACL.

  3. #3
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by ILuvRock View Post
    we usually bill 29888 for revision ACL.
    yes that works but he does this type of surgery BEFORE the ACL revision. Almost like an ACL revision prep-surgery.

  4. #4
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Wishing you the best of Luck with these cases!!! (while I'm shaking my head praying none of my docs even attempt to try this!!))
    Mary, CPC, CANPC, COSC

  5. #5
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by mbort View Post
    Wishing you the best of Luck with these cases!!! (while I'm shaking my head praying none of my docs even attempt to try this!!))
    Exactly what I was thinking as I coded this out!

  6. Default
    Quote Originally Posted by nyyankees View Post
    yes that works but he does this type of surgery BEFORE the ACL revision. Almost like an ACL revision prep-surgery.
    Huh...that doesn't make any sense to me why he would be doing that.

Similar Threads

  1. ACL Revision/Meniscal Reapir
    By cwilson3333 in forum Orthopaedics
    Replies: 1
    Last Post: 02-18-2014, 08:15 AM
  2. 2 stage ACL revision reconstruction
    By aalley in forum Orthopaedics
    Replies: 1
    Last Post: 01-16-2012, 02:43 PM
  3. Revision surgery, CPT help plz
    By Karen A. in forum OB/GYN
    Replies: 2
    Last Post: 02-08-2011, 09:08 AM
  4. Revision of an acl
    By JWINGES in forum Orthopaedics
    Replies: 4
    Last Post: 05-11-2009, 02:30 PM
  5. Knee Surgery -acl
    By codedog in forum Outpatient Facilities
    Replies: 2
    Last Post: 08-06-2008, 09:37 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.