R404

PDF page 620 / N40

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
PELVIS AND HIP
                                                                                              Asst         Surg         Anae
# R642 - closed reduction/internal fixation ........................................           6           502.30        8
# R627 - open reduction/fixation .......................................................       6           758.65        8
     Payment rules:
     1.F134 is not eligible for payment if percutaneous fixation of the sacrum or sacroiliac joint(s) is
       performed.
        2.F134 is not eligible for payment for application of a pelvic sling or MAST trousers to a pelvic
          fracture.
        3.E555 and E569 are not eligible for payment with F134 as this fee code includes rigid external
          fixation of anterior/posterior pelvic ring and/or percutaneous fixation of anterior pelvis.
        4.E569 is not eligible for payment with D059 for percutaneous fixation of the sacrum and/or
          unilateral SI joint as this is included in D059
        5.Open reduction of acetabular or femoral head or hip fracture or dislocations include
          arthrotomy and/or removal of loose body(ies) if performed.
        6.F101 includes reduction and fixation of trochanteric fracture if performed.
        7.R628 is not eligible for payment with D042
        [Commentary:
        Open reduction codes for pelvic fractures should only be claimed when the operative
        procedure includes exposure of the fracture with reduction and internal fixation. Minimally
        invasive, image-guided reduction without fracture exposure and with percutaneous fixation
        does not constitute open reduction.]
     Sacro-coccygeal
  UVC - closed reduction .................................................................                visit.fee
# D061 - open, removal of coccyx.....................................................            6         193.00          6
     Congenital/developmental dislocation of the hip
# R404 - closed reduction (includes tenotomy and cast) ..................                                  190.20          7
# R405 - repeat (includes cast) .........................................................                  131.80          6
# R406 - open reduction (includes tenotomy and arthrotomy) ..........                            7         472.35          7

Master, record 4632. Record Layout PDF, page 1.

R40420260401999999990000190200000000000000000000000000000111720000001117200

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.