Wiki TKA Coding Question

[WENDYBHOLLOWAY]

Patient has previous TKA that became infected. Doc takes patient to the OR for removal & placement of antibiotic spacer. Patient now clear of infection, doc takes patient back to the OR for 2nd stage revision to remove the antibiotic spacer & reimplantation of total knee both components implants.

Would you code the 2nd stage procedure as a revision of both components CPT code 27487 - or - code as a TKA - CPT code 27447?

I've coded this a thousand times - for some reason today I cannot seem to wrap my tired old brain around this!!!

Appreciate any and all opinions ~

Wendy B. Holloway, CPC
Albany, Ga.

 

[code4you123]

TKA-revision

Hi Wendy,

Based on the case details presented, you're right to code 27487 for the revision of the total knee. Don't forget modifier -58 and to code for the antibiotic spacer removal using 11982-58.

Marilu Perez Sumner, ACPAR, CBCS, RMC, CPC, COSC
LC Dallas, GA
2014 Education Officer

 

[WENDYBHOLLOWAY]

Thank you Marilu - I appreciate you taking the time to respond.

Have a great day!

Wendy

 

[coderguy1939]

You may want to consider 27447 rather than 27487. Per AAOS, 27487 would be incorrect for a reimplantation because revision surgery requires that an exchange of prosthesis be done at the same surgical session. You've indicated that your patient had already had the prosthesis removed. You'll also want to use V54.82 and V43.65 as DX codes. If this is a Medicare patient, you may want to see if there is an LCD. Our MAC will not accept these DX codes.