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ORIF basicervical hip fracture code

  1. #1
    Default ORIF basicervical hip fracture code
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    This is the first time I've come across this specific situation, so help figuring it out would be greatly appreciated! :0)

    Procedure perfomed is : ORIF right hip basicervical hip fracture with Synthes 10 mm diameter, 130-degree trochanteric femoral nail using a 100 mm helical screw in the femoral neck and a distal interlocking 32 mm corkscrew.

    Procedure notes state : incision was made along the greater trochanter through the gluteus medius fibers down to the greater trochanteric tip, where a guide ____ was inserted down the femoral shaft. Following this, a conical drill was inserted to allow insertion of the trochanteric femoral nail. Measurement of the canal revealed it to be approximately 10 mm, and a trochanteric femoral nail of 30 mm and 130-degree angle was chosen. This was placed ont a guide and inserted into the trochangeric region into the femoral shaft. After this, a guide was inserted onto the assembly of the trochanteric femoral nail to angle towards the femoral neck. An incision was made along the lateral femur through the skin and subcutaneous tissue through the tensor fascia lata adjacent to the lateral femur. Guidepin was inserted the lateral cortex into the femoral neck and head, measuring approx. 100 mm. Lateral cortex was drilled, followed by a conical drill to drill the 100 mm. Lateral cortex was drilled, followed by a conical drill to drill the 100mm, and subsequent insertion of 100 mm helical screw. Note that initially a 90 mm helical screw was inserted, which was too short, and it was replaced with the 100 mm helical screw. After this the guide was used for the distal interlocking screw, where extension of the lateral incision was performed, and then drill was for lateral cortex measuring 32 mm for interlocking screw. After the interlocking screw was placed and the locking screw was set at the proximal aspect of the femoral nail, the fracture was compressed.

    The biggest part of my confusion lies with the basicervical hip description, I'm thinking this is at the femoral neck, but I'm not totally sure. The 2 codes I was sort of kind of looking at are 27236, and 27248, I'm not even sure if either one of those is remotely close to right, but would really appreciate someone who has done more than a couple of these to help me! Thank you so much! :0)

  2. Default Steve J
    27236 is the correct code.

  3. Default
    I agree with 27236

  4. Default
    Unfortunately, all the above are incorrect. The term Basicervical fracture of the hip/femur is a variation of the terminology for a Base Neck fracture of the femur, also called Cervicotrochanteric fracture of the femur in ICD-10 (which has made a real mess of the organization and coding of proximal femoral fractures). This fracture occurs at the junction of the femoral neck with the trochanteric region of the femur, therefore it is in the "gray zone" between the neck and the trochanteric segments of the femur. The Dx code would be S72.041A, since it was probably displaced and right sided. It is usually treated like an Intertrochanteric fracture.
    The surgical procedure was open treatment with an Intramedullary Device with distal locking screw, which is 27245.

    I have tried to sort out and make sense of the issue of proximal femur fracture coding in a Blog called "Coding Hip Fractures" at my website: Click on the Blogs Tab and scroll through the Blogs, then click on the title, which will open it up. It may be of help to you.

    Respectfully submitted, Alan Pechacek, M.D.

  5. Default
    Thank you! I just came back to this post because I realized I put the wrong code! 27245 it is!

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