AHA Coding Clinic® for HCPCS - 2022 Issue 1; Ask the Editor

Ablation osteoplasty reinforcement internal fixation (AORIF)

A patient presented to the orthopedic oncology clinic with left hip pain as the result of an acetabular lesion with pathologic fracture. A decision was made to proceed with an ablation osteoplasty reinforcement internal fixation (AORIF). Three guidewires were advanced through small incisions from the anterior aspect of the iliac crest to the acetabulum under fluoroscopic guidance. After confirmation of the positioning of the guidewires, three cannulated screws were placed over the wires. The guidewires were removed from the two most anterior screws and radiofrequency ablation probes were placed into the acetabular lesion through the screws. The lesion was ablated for 15 minutes. Following removal of the ablation probes, kyphoplasty balloons were inserted into the same two most anterior screws to promote the delivery of cement. The balloons were inflated and removed. Cement was then injected through the screws into the spaces created by the balloons. The third guidewire was removed from the most posterior screw and cement was injected into that screw as well. The screws were then advanced to the level of the iliac crest. Fluoroscopy was used during cement injection and screw advancement. What is the CPT code for an AORIF procedure when internal fixation and ablation are performed through the same small incisions; utilizing guidewires, kyphoplasty balloons, fluoroscopy, cement, and screws? ...

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