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Tag Archives: Replacement
Unicompartment Knee replacement revision
I have a surgeon who did a poly exchange in both the medial and lateral compartments on a patient who had medial and lateral unicompartmental knee replacements. The OP report states:
Procedures performed: Right knee open irrigation and debridement with polytheylene liner exchange of medial and lateral unicompartmental arthroplasties.
Description: A thorough debridement of the entire joint was then undertaken. A quarter-inch osteotome was then used to remove the medial and lateral polyethylenes. 3L of normal saline were then irrigated throughout the joint with pulse irrigation. This was then followed by 1L of saline with Bacitracin, another 3L of sterile saline and finally by 1L of dilute Betadine wash. The dilute Betadine was allowed to sit in the joint for approximately 3 minutes before being irrigated out. Next, new polyethylenes were inserted into the medial and lateral tibial base plates.
Would I bill the knee revision code for 27486: Revision of total knee arthroplasty, with or without allograft; 1 component ? Even though it is technically 2 components?
I would normally bill the 27486 with a 52 modifier for poly exchanges of a conventional total knee, but have never come across a bilateral uni poly exchange.
Thanks for all your help!
Heather
UHC Replacement plan denying J7321 for NDC
Some of the UHC Medicare Advantage Replacement Plans are denying J7321 for NDC. J7321 does not have an NDC. My sources state it is regulated as a device. What should I do?
AX debridement for Pattella clunk status post knee Replacement
What CPT code are you using for this. My doctor wants to bill 29876 Synovectomy, major, 2 or more compartments. Some research has indicated code 29884 for Lysis of adhesions. The synovectomy code indicates resection of Pathologic Synovial disease and not to be used for simply "cleaning up the joint". He is removing scar tissue – not synovium. Interested in what others are using for this.
jont replacement aftercare codes
For how long after a joint replacement is it appropriate to report the aftercare code Z47.1?
(ie. patient had a right knee replacement done 5 years ago and comes to the office to have that knee checked and xrays taken, they have no complaints/problems.)
Thanks for your input!
Medicare denying 2018 radiology replacement codes
Our group is seeing a huge denial trend for the new radiology codes. Specifically 71045, 71046, 74019 with denial *TREATMENT NOT COVERED IN THIS SETTING/POS – 244. The place of services denying are 19 and 23.
I am getting nowhere with Medicare. I was advised to fax a general inquiry form for additional information.
Anyone else having the same issue, any advise?
Thank you!
Replacement of hardware 20680??
For a femur fracture a lag screw was exchanged and the set screws were tightened. The doctor coded it as a 20680 removal of implant; deep. However, no hardware was removed it was just replaced & tightened. Any suggestions on how this should be coded would be greatly appreciated!
Thank you
Thank you
Need payment information for combination Valve replacement with CABG
I work mainly as a coder and auditor, so it’s been quite a while since I’ve dealt with the reimbursement side, but I’ve been asked a question that I can’t find an answer for. When performing multiple procedures, the primary procedure is paid at 100% of the fee schedule and each subsequent procedure is paid at 50% of the fee schedule per the MPFS. Is there an additional reduction with Valve replacements and CABG done at the same time? I seem to remember an additional reduction to the CABG codes was also done, but I can’t find any documentation from Medicare (or any other payer) that explains reimbursement for these combined procedure situations.
Any help will be greatly appreciated!
insertion or replacement of cranial neurostimulator pulse
I have two questions: This is Humana insurance
1.) 61886 – insertion or replacement of cranial neurostimularor pulse with connection to 2 or more electrode arrays – Provider did bilateral – modifier 50 is not allowed unable to find any coding guidlines.
a.) coding – 61886 (LT)
61886 (RT)
or
61886 (LT)
61886 (59,RT)
2,) 61867 and 61868 – Humana paid 61867 but 61868 is done bilateral
a.) coding – 61868 (LT)
61868 (RT)
or
61868 (LT)
61868 (59,RT)
1.) 61886 – insertion or replacement of cranial neurostimularor pulse with connection to 2 or more electrode arrays – Provider did bilateral – modifier 50 is not allowed unable to find any coding guidlines.
a.) coding – 61886 (LT)
61886 (RT)
or
61886 (LT)
61886 (59,RT)
2,) 61867 and 61868 – Humana paid 61867 but 61868 is done bilateral
a.) coding – 61868 (LT)
61868 (RT)
or
61868 (LT)
61868 (59,RT)
Any help would be great or any documentation regarding this.
thanks
Medicare Replacement Plans vs. Medicare
Opinions needed: How often do most of you check eligibility on Medicare patients?