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Excision of exostosis of femur

  1. #1
    Default Excision of exostosis of femur
    Medical Coding Books

    The surgeon went in to remove an 8 plate but encountered a lot of bone overgrowth on the plate and had to remove it first before finally reaching the plate. He is calling this "removal of hypertrophic overgrowth of bone over the plate." The only two codes that come close are 27071 or 27360 but he is not near the trochanter nor is he distal, The descriptions of both of those codes do not seem to match what he did. The operative report reads: "I dessected through the subcu tissue down to the fascia. The fascia lata had partially reconstituted itself with the formation of some scar tissue over the quadriceps. I lifted up the quadriceps off the intramuscular septum and placed a Hohmann elevator around the femur at this level, in the midportion of the plate. About half of the surface of the plate was overgrown with bone from the femur. I used a small osteotome to chip away at this overgrown bone until I could see the entire exposed plate."

    Chipping away at the excess bone growth is not the same as cutting into the actual femur (unless I'm missing something). Does anyone have any suggestions as to what code would represent what he did?

    Thanks so much!

  2. Default
    Hi there, this one is pretty interesting, huh! I agree that neither code you cited is appropriate for this case. Have you considered just billing 20680, possibly with a 22 modifier and increased fee if the surgeon feels that this removal was above and beyond the norm?

  3. #3
    Thanks for your response. No, I hadn't considered using that but I will now! I suppose I could also use an unlisted code too. Thanks again!

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