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Wiki Total Knee Arthroplasty Revision SAME SESSION

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grobbins

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Doc performed a patient's first TKA. After all components were cemented into place and hardened, he noticed:

"However it was noted that the bone underlying the femoral component on the anterior cortex of the femur began to collapse. It was felt that this bone would not support a primary tibial component. At this point the decision was made to convert to a revision system with stems for additional fixation. Both the femur and tibia were removed with minimal bone loss using a combination of saws and osteotomes."

Would this be coded as a "Revision 27487" or a 27447 with a Modifier 22 for complexity?

Any feedback would be GREATLY appreciated!
 
Since the revision was necessary to complete the total knee replacement I would bill 27447-22.

Besides, the insurance carrier would most likely deny a bill for a revision since the patient didn't have a prosthesis prior to this surgery. (ETA: in other words, if the insurance carrier gets a bill for a knee replacement revision and they see that the patient never had surgery for a knee replacement they will deny it)
 
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