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Total Knee with Wound Closure

  1. Default Total Knee with Wound Closure
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    My Ortho has requested some previous Total Knees to be coded with an additional wound closure due to the size of the wound. (27477 and 12035-51)I am having trouble getting this paid with the carriers. Some pay it with proof of documentation, others do not.
    Can this actually be submitted with complicated open wound 891.1 even though he made the incision?
    Any suggesstions would be helpful.
    Thanks!!

  2. #2
    Location
    Lewiston, Maine
    Posts
    33
    Default
    I would suggest checking the AAOS complete global service package rules for lower extremities. I believe that the closure would be included since he is closing his operative wound for the total knee.
    Catherine Nolin, CPC, CGSC

  3. #3
    Default
    The AAOS Global Service Data states that 27447 includes "closure of wound & repair of tissues divided for initial surgical exposure, partial or complete (eg, 12001-13153"; therefore, the closure is included with the total knee. Also, dx 891.1 falls under the "Injury & Poisoning" section, so you can't use that - the doc made the wound. Hope this helps.

  4. Thumbs up
    THANKS SO MUCH!!! It's nice to have reinforcement!!!!
    - Patricia

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