Wiki Revision BKA Guidance Needed

[amelia04284]

Patient had initial BKA 15 years ago after fracturing ankle. Following operative fixation, subsequently developed osteomyelitis leading to the need for amputation. Has been doing well with prosthesis up until about a year ago when they started experiencing discomfort. Primary complaint is a tender piece of bone over the distal portion of stump. No injuries or trauma. No current evidence of infection or skin breakdown.

XR demonstrate bony overgrowth on distal portion of remaining tibia.

I know two possibilities are 27880 and 27886 but the description for 27886 states the re-amputation is due to nonhealing of the original stump or persistent infection - neither of which is true. But I would consider this to be "Other Complication of Amputation Stump" (T87.89XA) in which it does point me to 27886.

I may be overthinking this but I do not have much experience with amputations so any feedback/guidance would be appreciated!

 

[iowagirl77]

I'd go with 27886 for re-amputation since this is not the initial amputation. I'm not seeing the descriptor you have, only 'Amputation, leg, through tibia and fibula; re-amputation'.

 

[amyjph]

Agree 27886.
Be careful of reading lay terminology or examples in coding or "encoder" programs. As stated above, there is nothing in the official CPT description of 27886 that specifically indicates it is for non-healing or infection only.