Wiki Patella Arthroplasty with Medial Condyle Arthroplasty

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cwilson3333

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Medicare denied procedure CPT 27438 as inclusive in CPT 27446.
I see the CCI edits say this is correct, but other sites I have gone to, say these 2 procedures are separately billable.

Can someone shed some light on this situation?

Thanks,

CW
 
Were they separate knees? Did you use a 59 modifier? I would think if it was the same knee the patella would be included in the knee.
 
Knee Arthroplasty Codes

Surgery is on the same knee, but still finding conflicting answers on billing of CPT 27438,
Arthroplasty patella, and CPT 27446, Arthroplasty, knee condyle and plateau.

If it were 27447, total knee, then I would agree that 27438 is included.

Still not sure???

Hoping to get more responses.

CW
 
Physician is performing a patello-femoral arthroplasty right? That is billed as an unlisted code. If you read the description for 27446 includes the tibial plate which the physician does not touch for a pf arthoplasty. I have some additional info on this and can fax it to you if you like. Hope this helps a little. :)
 
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