Results 1 to 2 of 2

27134 & 27165

  1. Question 27134 & 27165
    Exam Training Packages
    We sent a claim to Medicare on a patient who had a revision of a total hip replacement. The physician revised both the femoral and acetabular components with a subtrochanteric femoral osteotomy and allograft bone grafting.

    We billed 27134 with 27165-51 - we didn't think 59 would be appropriate since there was not a separate incision and the procedures were done in the same area. Medicare paid the 27134 but not the 27165-51 - the code on the denial is CO-B15 with a remark code of M80.

    The GSD lists 27165 in the "not included" section under 27134. We feel this can be appealed but aren't sure if just sending the OP report will suffice.

    Any input, as always, is greatly appreciated.

  2. #2
    Unfortunately, Medicare follows CCI Version 15.3 which does include 27165 as inclusive.

    I suggest appealing to Medicare with your GSD information showing them that a board of Orthopedic peers indicate that it should NOT be inclusive and you may be succesfull. I have appealed and received payment.

    Melodie Alery, COSC

Similar Threads

  1. Replies: 0
    Last Post: 08-07-2015, 01:40 PM
  2. 27134 vs 27137,27138
    By spebuck in forum Orthopaedics
    Replies: 1
    Last Post: 02-27-2014, 01:16 PM
  3. ICD9 allowable coding for 93880 & 83882 & 93875
    By twinger in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-14-2014, 01:09 PM
  4. 27134 & 27269
    By Sara82 in forum Orthopaedics
    Replies: 0
    Last Post: 07-29-2011, 03:13 PM
  5. Hip Revision 21737 or 27134
    By CrysLednum in forum Orthopaedics
    Replies: 2
    Last Post: 05-29-2009, 12:18 PM

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?


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.