Results 1 to 5 of 5

knee revision arthroplasty

  1. Default knee revision arthroplasty
    Medical Coding Books
    Patient had a total knee arthroplasty (27447), but later developed infection, and the surgeon removed the prosthesis and inserted a spacer ( 27488). Now the surgeon is again
    implanting the knee prosthesis. My question is do I code it as a revision? That was my first choice, but then, he is not removing a prosthesis, because he had removed it in a previous procedure. Or should I again code as a 27447 . . . . This is the first time I have come across this situation, and would be grateful for any help, as I am really confused at this point

  2. #2
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by wsr1614@yahoo.com View Post
    Patient had a total knee arthroplasty (27447), but later developed infection, and the surgeon removed the prosthesis and inserted a spacer ( 27488). Now the surgeon is again
    implanting the knee prosthesis. My question is do I code it as a revision? That was my first choice, but then, he is not removing a prosthesis, because he had removed it in a previous procedure. Or should I again code as a 27447 . . . . This is the first time I have come across this situation, and would be grateful for any help, as I am really confused at this point
    It's considred a conversion. Since there is no Knee Conversion code you would use 27447. You can add a 22 modifier if the doc documents any altered surgical field or increased difficulty.

  3. Default
    You'd want to use -58 also.
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC
    www.ncspecialty.com

  4. #4
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by bcrandall View Post
    you'd want to use -58 also. :d
    yes!!

  5. Default I found this article. Thanks everyone for your help
    A 2-stage procedure
    What happens when the surgery is not so straightforward and the procedure has to be done in stages? Assume a situation in which the surgeon removes a knee prosthesis and inserts cement or a prosthetic spacer at the time the implant is removed. If this procedure is performed outside the global period of the original surgery, it would be reported using code 27488—Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee.

    Six weeks later, the same surgeon brings the patient back to the operating room to remove the spacer and replace it with the definitive knee prosthesis. This procedure would be reported using code 27447-58, 22—Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty).

    Reporting either of these surgeries with the revision code 27487 would be incorrect because the CPT code that describes total knee revision surgery requires that the exchange to the definitive prosthesis be done in the same surgical session.

Similar Threads

  1. Replies: 0
    Last Post: 05-15-2012, 12:45 PM
  2. knee revision arthroplasty
    By scooter1 in forum Orthopaedics
    Replies: 1
    Last Post: 05-08-2012, 11:00 AM
  3. revision unicompartmental knee arthroplasty
    By maryanneheath in forum Orthopaedics
    Replies: 1
    Last Post: 07-12-2011, 10:11 AM
  4. 2nd stage knee arthroplasty revision
    By donsqueen in forum Orthopaedics
    Replies: 3
    Last Post: 12-08-2010, 08:25 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.