DecisionHealth, DecisionHealth - 2023 Issue 8 (August)

Q&A: How to report a pelvis/hip fracture repair with two different surgeons

Question: I have two surgeons in our group who each did a separate procedure on the same patient on the same day. Dr. N. did an open reduction with internal fixation (ORIF) of an acetabulum to address a pelvic fracture. Dr. S did a total hip arthroplasty for a femoral head fracture. We were looking to report CPT code 27228 for the ORIF and 27130 for the hip arthroplasty. But those codes are bundled according to Medicare’s National Correct Coding Initiative (CCI), and because both surgeons are billing from the same practice, we can’t override the edit. Can you please help?

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