Monday 4 November 2013


Orthopaedic Codes:
The Hip and Knee replacement procedures are also often miscoded.
The following codes are usually appropriate to charge in these specific procedures, but must be modified according to procedures actually performed by the anaesthesiologist and according to specific rules applicable.
Modifiers such as 0018 (BMI >35.0) and 0043 (Age > 70years) may apply and should be charged as appropriate.
Hip Replacement
Code
Description
Notes
0151
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Problem focused history and clinical examination and straightforward decision making for minor problem. Typically occupies the doctor face-to-face with the patient for between 10 and 20 minutes
 
0637
Hip: Total replacement
 
5445
Spine (except coccyx), pelvis, hip, neck of femur: Add five (5,00) anaesthetic units
 
0023
Anaesthetic time: The remuneration for anaesthetic time shall be per 15 minute period or part thereof, calculated from the commencement of the anaesthetic.
 
0039
Control of blood pressure: Deliberate control of the blood pressure: All cases up to one hour: Add 3,00 anaesthetic units, thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part thereof
 
2801
Procedures for pain relief: Epidural injection for pain (refer to modifier 0045 for post-operative pain relief) (refer to modifier 0021 for epidural anaesthetic)
If epidural block is performed for post-operative pain control
2804
Inserting an indwelling nerve catheter (includes removal of catheter) (not for bolus technique)
If epidural catheter is placed for post-op pain control
1221
Professional fee for managing a patient-controlled analgesic pump: First 24 hours (for subsequent days charged the appropriate hospital follow-up consultation/visit code)
If PCA/pump is placed for post-op pain control
0109
Hospital follow-up visit to patient in ward or nursing facility - Refer to general rule G(a) for post-operative care) (may only be charged once per day) (not to be used with items 0111, 0145, 0146, 0147 or ICU items 1204-1214)
Appropriate if patient is seen in hospital on subsequent day for monitoring of pain control
 
 Knee replacement
Code
Description
Notes
0151
Pre-anaesthetic assessment
 
0646
Knee: Total replacement
 
5442
Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible and tempero-mandibular joint: Add two (2,00) anaesthetic units
 
0023
Anaesthetic time: The remuneration for anaesthetic time shall be per 15 minute period or part thereof.
 
2802
Procedures for pain relief: Peripheral nerve block
If femoral block is done
2804
Inserting an indwelling nerve catheter (includes removal of catheter) (not for bolus technique)
If catheter is used with the femoral block
1221
Professional fee for managing a patient-controlled analgesic pump: First 24 hours (for subsequent days charged the appropriate hospital follow-up consultation/visit code)
If PCA is used with catheter in the femoral block, this code is appropriate.
 
Arthroscopy knee
Code
Description
Notes
0151
Pre-anaesthetic assessment
 
0614/0673
0614
Arthroplasty: Debridement large joints
0673
Meniscectomy or operation for other internal derangement of knee
 
5442
Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible and tempero-mandibular joint: Add two (2,00) anaesthetic units
 
0023
Anaesthetic time.
 
 

No comments:

Post a Comment