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proximal tibial autograft for ankle arthrodesis

Anh Posted Mon 09th of March, 2015 18:40:45 PM

not sure how to code for obtaining proximal tibial autograft for ankle arthrodesis, want to use 27870 but my doctor wants the proximal tibial autograft with 4 base units, Please advise.

SuperCoder Answered Tue 10th of March, 2015 05:24:36 AM

Hi Anh,

Thank you for the query.

We can use CPT code 20900 or 20902 to report proximal tibial autograft, as the autograft has been taken from the separate site from the operative field.

Also, CPT codes 20900 and 20902 are size dependent code, not the autograft unit dependent. So, you can use the appropriate code as per the size used.

Hope it helps!

Anh Posted Tue 10th of March, 2015 11:40:24 AM

thank you for responding promptly to my question, but 20900 crossed to 01830 (anesthesia for distal radius, distal ulna, wrist, or hand joints) and 01112 ( anesthesia for iliac crest). Don't know what to do now. Please help

SuperCoder Answered Wed 11th of March, 2015 03:12:22 AM

Hi Anh,

As your primary procedure performed was on Ankle which is 27870 and RVU value is high for this procedure so we can append the anesthesia code as 01480.

The code 20900 proximal tibial autograft which is not the primary and has low RVU so it is not required to code 01830 (anesthesia for distal radius, distal ulna, wrist, or hand joints) and 01112 ( anesthesia for iliac crest).

Hope it helps!

Anh Posted Wed 11th of March, 2015 11:46:31 AM

thank you, but I'm confuse, 01480 has an RVU of 3 not 4, neither of 01830 (3 RVU) or 01112 (5 RVU) is for proximal tibia. please clarify.

SuperCoder Answered Thu 12th of March, 2015 02:19:19 AM

Hi Anh,

There will not be any RVU value for anesthesia codes.
An illustration of the formula by which an anesthesia charge is calculated is illustrated below:

(Base units + Time units + Modifying units) x $ Conversion Factor = Anesthesia Charge.

The amount of time the procedure requires is calculated according to time units. Billable time starts when the anesthesia provider begins preparation of the patient for anesthesia in the operating room or equivalent area, and ends when the patient is safely placed under post-anesthetic supervision and care. The amount of time assigned per unit varies throughout the United States from 6 to 15 minute increments.

Hope it helps!

Anh Posted Thu 12th of March, 2015 13:15:58 PM

What I meant is base units for 01830 (anesthesia for distal radius, distal ulna, wrist, or hand joints) and 01112 ( anesthesia for iliac crest), I can't use 20900 for proximal tibial autograft. Any advise, thank you.

SuperCoder Answered Fri 13th of March, 2015 02:12:24 AM

Anh,

As per your above mentioned documentation we can code only the codes which I mentioned. We cannot code high dollar value codes without having proper documentation and procedures performed by the provider.

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