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Thread: 27344-59?

  1. #1
    Join Date
    Apr 2007
    Modesto, CA; Central Valley Chapter

    Default 27344-59?

    AAPC: Back to School
    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?

    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

    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....



  2. #2
    Join Date
    Apr 2007


    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.

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