Orthopedic Coding Alert

Question: Our surgeon performed a total knee replacement, but after the glue hardened, the exam showed that the knee was unstable. The surgeon then did a revision of both components, but he performed all of these procedures during the same OR session. Should we use 27447 and 27487-58?

Answer: When your surgeon must perform more than one procedure to complete a successful surgery, you should only report the code for the procedure that accomplishes the intended outcome. In this case, that would be 27447 (Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing [total knee arthroplasty]).

Because the patient did not leave the operating room between surgeries, you cannot report 27487-58 (Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component; Staged or related procedure or service by the same physician during the postoperative period) in addition to 27447. Remember, you should not code for treating errors a physician might have made.