Get Paid for Your Hip Procedures With Smart Orthopedic Coding

Mon, Feb 29, 2016 --

CPT Codes

Orthopedic surgery coding

Confused about orthopedic coding guidelines for hip surgery? Read on for tips on correct coding for two types of procedures on this joint.

Look for Rules on Total Hip Replacement and Osteotomy

What happens when a surgeon performs a subtrochanteric osteotomy on a patient who suffered a slipped capital femoral epiphysis, and then three years later, because the patient developed osteoarthritis of the hip, the surgeon has to come back and perform total hip arthroplasty?

First, a little background on this condition. Slipped capital femoral epiphysis occurs in adolescents when the top of the thigh bone, the femoral epiphysis, which is the ball portion of this ball-and-socket joint, slips out of its place in the acetabulum, or socket. Surgeons sometimes pronounce the acronym for this condition, SCFE, as “skiffy.” Because adolescents usually need surgical fixation for this procedure to prevent the growth plates from moving out of alignment, surgeons often perform a subtrochanteric osteotomy procedure to repair this condition, which can include screw fixation of the fracture. Later development of osteoarthritis is a common complication of this condition.

When a patient has already had a subtrochanteric osteotomy in the past, then requires that procedure again as part of a total hip arthoplasty, what code is appropriate to report? Without a doubt, you would report 27132 (Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft.) The question is whether you can report the second occurrence of osteotomy. The Correct Coding Initiative doesn’t bundle 27165 (Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast) into 27132, but insurers may not reimburse for both procedures. Before you report both codes, check with the payer. If they do allow you to report both procedures, list them on your orthopedic coding claim this way:

  • 27132
  • 27165-51 (Multiple procedures).

Learn to Code a Girdlestone

In a Girdlestone resection, surgeons remove the femoral head and neck, usually because of cases of severe hip infection. This means no hip joint remains. Though this is not an everyday procedure, at least it’s straightforward to code. For this procedure, you should report 27122 (Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure).

What About You?

Do you run into these procedures very often? Any tips for successful reimbursement that we forgot? Let us know in the comment box below. We love to hear from you!

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About 

Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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1 Comments For This Post

  1. Drew Says:

    Great advice for learning about your hip replacements. The more you know before your procedure the less stressed you may be.

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