Wiki Patellofemoral arthroplasty - I'm hoping someone can help me

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kjstearns

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I'm hoping someone can help me out with this...
Dr. performed a patellofemoral arthroplasty and chose codes 27438 and 27442. I'm showing that 27442 is mutually exclusive to column 1 code 27438. 27442 has the higher RVU though.
Has anyone else billed for this procedure? It seems like both codes should be billable. Which one do I use?

Thanks in advance for any help!!

~Kirsten, CPC
 
Patellofemoral Joint Replacement

Coding Clinic for HCPCS, First Quarter 2016: Page 4

Coding advice contained in this issue is effective with procedures/services provided after April 15, 2016, unless otherwise noted.

QUESTION 4

Patient presents to have a left patellofemoral replacement. The surface of the femur was prepared for insertion of the femoral trochlear implant. Then the surface of the patella was resected for the insertion of the patellar button. The bone cement was mixed and the femoral trochlear implant was cemented into place along with the patellar button component and held into place until cement hardened. There was good alignment and the area was closed. We want to report 27438 and 27442 but an NCCI edit exists. How is a patellofemoral joint replacement reported?

ANSWER

CPT code 27438, Arthroplasty, patella; with prosthesis, would be reported for the procedure performed regardless of whether 1 or 2 components were implanted. Please note that it would be inappropriate to report CPT code 27442, Arthroplasty, femoral condyles or tibial plateau(s), knee, separately as both procedures were performed in the same knee joint.
 
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