In the OP note below the provider is removing prosthesis of the knee - 27488 due to infection. However, he also did an extensive synovectomy (27334). I see that a modifier is allowed; how can I be sure that it is appropriate in this situation to add the CPT code and modifier?
INDICATIONS FOR PROCEDURE
The patient is a 63-year-old male with left infected knee with a total knee
arthroplasty in place. He does have cultures, which are positive for
Staphylococcus aureus. Risks and benefits have been discussed. Risks include,
but are not limited to infection, bleeding, neurovascular injury, blood clots,
persistent pain, and even death. He also understands there is even the risk of
loss of limb if infection persists. He also understands this is a stage
DETAILS OF PROCEDURE
The patient was brought to the operating room and general anesthesia induced.
The patient was on preoperative vancomycin. Left lower extremity prepped and
draped in standard fashion. A well-padded tourniquet was applied and inflated
to 300 mmHg. Correct surgical site was identified. Sponge and needle counts
were correct at the completion of the case. A standard anterior approach to
the knee was made followed by medial peripatellar approach. Gross purulence
was found in the knee joint itself. Cultures were sent. Extensive synovectomy
was performed. The medial soft tissue sleeve was dissected off the
posteromedial aspect of the tibia and a full-thickness flap.
The report goes on to describe the removal of the prosthesis....
According to the AAOS Global Service Data, 27488 includes "synovectomy, partial or complete (eg, 27334, 27335, 29875, 29876)". Since CCI & AAOS both say the synovectomy is included, I wouldn't bill for the 27334.