decisionhealth Newsletters, Coder Pink Sheets - 2024 Issue 10 (October)
Q&A: How to bill when first attempt at total hip is aborted
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Article Overview
This article is a coding Q&A for orthopedic surgery billing, focused on how to report a total hip arthroplasty when an earlier attempt was discontinued and a later attempt was completed. It explains the general claim-processing issue involved, including the interaction with the postoperative global period and modifier selection, and is most relevant to surgical coders, billing staff, and revenue cycle teams working with Medicare Advantage or similar payer policies.
Why This Topic Matters
Interrupted surgeries can affect how the original claim is reported and how the later completed procedure is paid. Readers need to understand the billing context, the role of the global period, and the payer implications before submitting the final claim.
What You Will Learn
- How billing is discussed when an initial surgical attempt is discontinued and a later procedure is completed.
- What general postoperative/global period issues may arise after an aborted surgery.
- Which broad modifier category is discussed in relation to the return procedure.
- How payer payment behavior may differ after an interrupted operative case.
Who Should Read This
- Professional coders
- Surgical billing staff
- Orthopedic practice managers
- Revenue cycle teams
- Compliance staff
Codes Discussed
Modifiers Discussed
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