Results 1 to 2 of 2

Need HELP on codes for replacing screws on a previous fusion

  1. #1
    Default Need HELP on codes for replacing screws on a previous fusion
    Medical Coding Books

    Can anyone help me with this op report?

    DX: nonunion of right tibia

    Procedures: application of external fixator to femur and tibia, code 20692, to treat tibial nonunion, and insertion of new screws into the knee fusion rod.

    Indications for procedure; This person who had a nonunion of their right tibia treated with a plate and bone grafting previously. One week ago the plate had become infected and this was removed along with exchange of the locking screws. Upon visualizing the postoperative radiographs, it was noted that the screws were not through the rod, and the nonunion site was gapped open. This was secondary to the fact that the plate had been also removed. Since the nonunion did not have enough stability, we elected to return to the OR to put an external fixator on to stay away from the region of the previous plate application and to revive the distal tibial interlocking screws in the knee fusion rod.

    Following the ex fix application (I left that out on purpose) the previous interlocking screws that were at the ankle were then removed, and the drill holes into the intramedullary rod were then filled with Plexur M, and then these were redrilled and rescrewed. The screws had good purchase and were confirmed on the AP and lateral x-rays to be through the rod.

    Is there a code to represent replacing the screws? Would it be 27745?


  2. #2
    Coeur d'Alene, Idaho
    We just had this question come up a couple weeks ago and we determined that we had to go with the unlisted code 27899 for replacement of the screws. CPT 27745 doesn't quite sound right to me as it is for prophylactic treatment and this does not sound like that was the case. You can of course also bill the removal of implant; deep 20680 for removal of the previous screws.
    Casey Hamilton, BA, CPC

    Providence Physician Services
    Spokane Valley, WA

Similar Threads

  1. Previous posting of VATS codes
    By dvance4210 in forum Cardiovascular Thoracic
    Replies: 2
    Last Post: 02-25-2015, 08:25 AM
  2. Help with codes, spinal fusion T11-L4
    By in forum Orthopaedics
    Replies: 1
    Last Post: 10-02-2014, 10:00 AM
  3. help w/fusion codes please!!!
    By RHENZ06ily in forum Orthopaedics
    Replies: 0
    Last Post: 09-29-2011, 02:36 PM
  4. Replies: 4
    Last Post: 06-30-2011, 08:03 PM
  5. Question re: fusion with osteotomy codes
    By malissagiles in forum Orthopaedics
    Replies: 1
    Last Post: 02-24-2011, 03:51 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.