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CPT 27266 regional or general anesthesia?

Kelly Posted Tue 22nd of January, 2013 19:46:52 PM

I am being told that this procedure does not qualify using CPT 27266. Is that correct?

Prosthetic Hip Dislocation:

Conscious sedation protocol used. Time out called. She had Morphine and Fentanyl prior to the procedure.
Propofol, 50mg then 40 then 40mg. ETCO-2 remained in high 30's. Oxygen remained greater than 90%. Reduced w/u difficulty with longitudinal traction with the hip flexed at 90 degrees.

SuperCoder Answered Wed 23rd of January, 2013 15:15:20 PM

A closed hip reduction performed on a dislocated hip that has previously undergone total hip replacement requires that code 996.42 Dislocation of a prosthetic joint, be submitted as the appropriate diagnosis code and not a code from subcategory 835.0x for closed dislocation of hip. Closed reduction performed in this case can be reported with either CPT code 27265 Closed treatment of post hip arthroplasty dislocation; without anesthesia or 27266 Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia.

Notice that the 27266 descriptor helpfully explains the types of anesthesia that qualify (regional or general).

ICD-9: The appropriate diagnosis codes for these dislocations are 996.42 (Mechanical complication of internal orthopedic device, implant, and graft; dislocation of prosthetic joint) and V43.64 (Organ or tissue replaced by other means; joint; hip)

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