Efficient orthopedic medical billing services can help practices submit clean claims for surgical procedures and other services.
Orthopedic surgery is recommended when non-surgical approaches do not work. Orthopedic surgery is performed on the musculoskeletal system – the bones, muscles, ligaments, joints and tendons. Based on the injury or damage type, surgery is performed on different areas such as the shoulder, ankle, hip, knee, wrists, elbow and spine. Orthopedists can rely on medical billing and coding companies to correctly report their services on claims.
Here are the common types of orthopedic surgery procedures and their ICD-10 and CPT codes:
Hip replacement surgery or hip arthroplasty
ICD-10-PCS Codes
- 0SP90JZ Removal of Synthetic Substitute from Right Hip Joint, Open Approach
- 0SPB0JZ Removal of Synthetic Substitute from Left Hip Joint, Open Approach
- 0SR9019 Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach
- 0SR901A Replacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach
- 0SR901Z Replacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach
- 0SR9029 Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach
- 0SR902A Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach
- 0SR902Z Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach
CPT codes
- 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
- 27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
- 27134 Revision of total hip arthroplasty; both components, with or without autograft or allograft
- 27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
- 27138 Revision of total hip arthroplasty; femoral component only, with or without allograft
ACL Reconstruction Surgery:
- 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
Total Knee Arthroplasty
ICD-10-PCS codes
- 0SPC0JZ Removal of Synthetic Substitute from Right Knee Joint, Open Approach
- 0SPD0JZ Removal of Synthetic Substitute from Left Knee Joint, Open Approach
- 0SRC069 Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach
- 0SRC06A Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Uncemented, Open
- 0SRC06Z Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Open Approach
- 0SRC07Z Replacement of Right Knee Joint with Autologous Tissue Substitute, Open Approach
- 0SRC0EZ Replacement of Right Knee Joint with Articulating Spacer, Open Approach
CPT codes
- 27445 Arthroplasty, knee, hinge prosthesis (eg, walldius type)
- 27447 Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)
- 27486 Revision of total knee arthroplasty, with or without allograft; 1 component
- 27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
Shoulder Arthroscopy
CPT codes
- 29822 Arthroscopy, shoulder, surgical; debridement, limited includes debridement of soft or hard tissue
- 29823 Arthroscopy, shoulder, surgical; debridement, extensive includes debridement of multiple soft structures, multiple hard structures, or a combination of both
The extensive debridement (CPT® 29823) performed in a different area of the same shoulder with any of the following arthroscopic shoulder procedures can be reported separately-
- 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)
- 29827 with rotator cuff repair
- 29828 biceps tenodesis
Carpal tunnel surgery
CPT
- 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel
- 29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament
ICD-10
- G56.0 – Carpal tunnel syndrome
- G56.00 – Carpal tunnel syndrome, unspecified upper limb
- G56.01 – Carpal tunnel syndrome, right upper limb
- G56.02 – Carpal tunnel syndrome, left upper limb
- G56.03 – Carpal tunnel syndrome, bilateral upper limbs
Professional orthopedic medical billing services are available to help with everything from patient enrollment and verification to coding, claims submission and accounts receivable management. Leading companies have expert teams that stay up to date with coding changes, and payer and industry guidelines. They can help practices maintain billing and coding compliance, prevent denials and get optimal reimbursement for services rendered.