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Femur FX Repaired Through Separate Incision While Doing a THA

Kirsten Posted Fri 18th of December, 2015 11:46:33 AM

While performing a Total Hip Arthroplasty, the surgeon accidently cracked the femur when he was broaching the trials. He was able to cable the proximal part of the fracture through the THA incision, but because it was a spiral fracture, he had to make a separate incision and use a plate and screws to repair the midshaft/distal portion of the fracture. Can we charge separately for the ORIF of a midshaft femur fracture since it was through a separate incision? Or is this a case of "You-broke-it-you-fix-it" without reimbursement?

SuperCoder Answered Mon 21st of December, 2015 08:03:54 AM

Thanks for the Query

As per CPT coding rule, any accidental injury, while performing a main surgery, when repaired, is not eligible for separate reimbursement. The payment for that repair of the accidental injury is included within the payment for main surgery.
If the repair of accidental injury part is being taken care of by another surgeon, you can bill it separately.

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