Wiki Infected Total Knee removal and knee fusion

[mindyanna]

Good Morning my fellow coders. I have a physician who constantly is removing an infected total knee and putting in an antibiotic coated rod from the tip of the femur to the bottom of the tibia. She is calling this a knee fusion but I think it's just a static spacer until the infection is gone. She was told that she could bill the fusion if it were a permanent fusion so of course she documents that it's permanent. 6 months later she is removing this "permanent fusion" and replacing it with another total knee. I was under the impression that permanent means it doesn't come out. What are your thoughts on this? Do you think she should be allowed to bill out a 27580 instead of using the 27310? Anyone have any documentation I can look at that states the types of spacers used from a credible source?

Thanks in advance

 

[ksobota]

What about 27488 & 11981 for the removal and placement of the spacer? Then when she goes back in to remove use 27447. Just some thoughts.

 

[Orthocoderpgu]

This seems very odd. When a knee prosthesis becomes infected it is taken out and an antibiotic spacer is placed. It does have a joint so the patient can move. The antibiotic spacer is usually in 6-8 weeks to get rid of the infection. Then new components are put in. I've never heard of a rod being used. In my opinion, I would never consider an antibiotic spacer "permanent" no matter how its "labeled". They are meant to get rid of the infection and then be replaced. If the spacer is "permanent" there would need to be a reason to replace it later on. If there's no "problem" with the rod six months later, what's the medical necessity to replace it other than it was not meant to be permanent anyway?