Wiki 27487 versus 27447

[Karen78]

My surgeon has performed a revision of total knee arthroplasty. We billed 27487 for the revision, however, the hospital is billing 27447 and removal 27488 which in turns corrupts our billing bundle for this medicare patient. Has anyone come across something like this? The hospital is stating "that since the components were removed and replaced, this procedure should be coded as a replacement procedure. Additionally, the removal of the previously placed componenets should be separately reported. And although revision may be documented by the surgeon, according to the icd-10-pcs' definition of the root operation "revision", a revision should be reported when teh objective of the procedure is to correct the position or function of a previously placed device, without taking out and putting a whole new device in its place. A complete redo of a procedure is coded to the root operation performed, in this case, a removal and replacement."

any advice on this???

 

[clark.amy86]

My surgeon has performed a revision of total knee arthroplasty. We billed 27487 for the revision, however, the hospital is billing 27447 and removal 27488 which in turns corrupts our billing bundle for this medicare patient. Has anyone come across something like this? The hospital is stating "that since the components were removed and replaced, this procedure should be coded as a replacement procedure. Additionally, the removal of the previously placed componenets should be separately reported. And although revision may be documented by the surgeon, according to the icd-10-pcs' definition of the root operation "revision", a revision should be reported when teh objective of the procedure is to correct the position or function of a previously placed device, without taking out and putting a whole new device in its place. A complete redo of a procedure is coded to the root operation performed, in this case, a removal and replacement."

any advice on this???

It has been quite some time since your original post, but I am responding in case someone has the same question in the future.

100%, I agree that this is a revision. 27487 would be the correct code when the components are removed and replaced during the same session. As for what the hospital said, I have never heard that before and I would be interested in where they got their information from. Also, 27488 is typically used for patients with an infection and includes the insertion of a non-articulating spacer.