Private payers get hip to new resurfacing treatment

Why This Topic Matters

Coverage policies for hip resurfacing varied widely, so coders and billers needed to understand how different payers approached the procedure and how those policies interacted with CPT-based reporting and broader compliance concerns.

Article Sections

1. Coding dispute over hip resurfacing

   Introduces the payer coverage trend and the resulting disagreement about how hip resurfacing procedures were being reported. Discusses the roles of CPT guidance and orthopedic coding commentary.

2. FDA approval triggers new interest

   Reviews the broader clinical and coverage context that increased payer attention to hip resurfacing. Summarizes why the procedure was drawing interest as an alternative to traditional hip replacement.

3. AAOS: hip resurfacing = arthroplasty

   Summarizes orthopedic coding committee views on how the procedure fit within established arthroplasty concepts. Includes discussion of later confirmation regarding total and partial resurfacing reporting.

4. Keep an eye on coverage policies

   Addresses the importance of checking individual payer policies and managing communication around coverage limitations. Notes the need for caution when payer policy and reporting approaches do not align.

5. Private payer policies for hip resurfacing

   Provides a payer-by-payer overview of selected private coverage policies and effective dates. The section is presented as a quick-reference summary of how different insurers were handling the procedure.