Orthopedic Coding Alert

Answer:You have several choices in this instance. Your first option is to report 27486-52 (Revision of total knee arthroplasty, with or without allograft; 1 component; reduced services) if the surgeon revises the liner due to wear or breakage. In other words, this code applies because the surgeon is revising part of the tibial component (the liner) while retaining the existing tray.

 

If the patient has an infection, and the surgeon removes the liner to allow access to the posterior knee for clean-out, then CPT® directs you to report code 27310 (Arthrotomy, knee, with exploration, drainage, or removal of foreign body [e.g., infection]).

 

Your other option is to report 27599 (Unlisted procedure, femur or knee) for the surgeon’s work performing the liner exchange. 

 

In any case, you should submit the surgeon’s op report with your claim, along with a letter from the surgeon explaining what he performed and how much reimbursement he requests for the procedure.