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Thread: Revision Hip Replacement/Femur Fracture

  1. #1

    Red face Revision Hip Replacement/Femur Fracture

    AAPC: Back to School
    Pre-op Dx:
    Periprosthetic right femur fracture
    Total Hip Replacement 4 months prior
    With Shortening Right Lower Extremity

    1. Revision of Right Femoral Stem to Restoration Modular Stem
    2. Extended trochanteric osteotomy for implant removal

    Questions re coding:
    1. CPT 27138 for revision femoral stem

    Implant removal took 1 hour to disimpact, so extended trochanteric osteotomy done.
    Cables placed around femoral stem to protect against further fracture
    Do I charge for "fracture tx" and what CPT or do I modify 27138 with "22" for
    the additional work?

    Need some direction on correct coding.



  2. #2

    Unhappy hip revision/femur fracture

    Still waiting for "someone" to reply.

  3. #3
    Join Date
    Apr 2007


    In my experience, the insurances will most likely not pay for both
    27138 and an Osteotomy as well (although they are not bundled)

    I would be more inclined to bill the 27138 with a -22 modifier and as long as the documentation shows the surgeon spent an excessive amount of time to accomplish the revision and it warrants the 22.

    IMO....good luck

  4. #4

    Thumbs up Hip Replacement/Hip Fracture


    I was thinking along those lines, too. This surgery ended up being a 5-hour surgery, so I think the 22 modifier definitely should be added.


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