Orthopedic Coding Alert

Question: My physician performed a right knee arthrotomy revision with a single-component exchange of polyethylene along with an extensive synovectomy. The operative note states: "Once the knee was opened, the knee was flexed and cultures were taken. Synovitis was encountered. We cleaned the suprapatellar fossa, medial and lateral gutters. We did remove the 10 poly, this allowed us access to the posterior aspect of the knee, where further synovectomy was done." According to the orthopedist, she had to remove the poly due to inflammation and suspicion of infection. Can I report codes for the arthrotomy and the synovectomy?

Rhode Island Subscriber

Answer: You probably shouldn't report an arthroplasty and a synovectomy code. On the claim, report 27310 (Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)) or 27335 (Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area) for the service.

Explanation: Judging from the encounter description, one of these two codes will cover all of the work units for your provider's service. Check the encounter notes or ask a provider if you need more guidance as to which of the two codes is more appropriate for your particular scenario.