# *HELP*Patellofemoral Joint Replacement



## tbensonite (Jul 23, 2014)

So I've been searching high and low and I cannot decide if this procedure is 27442 *only* or in conjunction with 27438. NCCI edits wants to bundle them but I thought I read that you could bill together with a 59 modifier with 27442. Can somebody shed some light on this for me please?

Thanks so much.


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## angelo_valencia (Jul 23, 2014)

*Patellofemoral joint replacement*

You have to code both 27442 and 27438 -59.  Try it in this sequence since 27442 has a higher RVU.


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## dclark7 (Jul 24, 2014)

You could get a more accurate answer if you post a redacted op note.


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## tbensonite (Jul 24, 2014)

*PF Arthroplasty*



angelo_valencia said:


> You have to code both 27442 and 27438 -59.  Try it in this sequence since 27442 has a higher RVU.



Aha! That's what I thought. Thanks so much


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## Rufus186 (Jan 27, 2015)

*cpt confirmation on patellofemoral resurfacing*

Procedure patellofemoral resurfacing using femoral component and patellar button

Dr performed patella osteotomy protected with a 35 mm plate and subluxed into the gutter.  Sulcus had a 3 degree cut and "tongue" femoral component and patella component was drilled in place.

I have used unlisted in the past similar to total 27447.  If unlisted is not acceptable would 27442 and 27438-59 be the correct coding since the dr did not address the patella alone?  Any insight would be appreciated!

Thanks


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## codegirl0422 (Oct 3, 2017)

Patellofemoral Joint Replacement

Coding Clinic for HCPCS, First Quarter 2016: Page 4 

Coding advice contained in this issue is effective with procedures/services provided after April 15, 2016, unless otherwise noted. 

QUESTION 4

Patient presents to have a left patellofemoral replacement. The surface of the femur was prepared for insertion of the femoral trochlear implant. Then the surface of the patella was resected for the insertion of the patellar button. The bone cement was mixed and the femoral trochlear implant was cemented into place along with the patellar button component and held into place until cement hardened. There was good alignment and the area was closed. We want to report 27438 and 27442 but an NCCI edit exists. How is a patellofemoral joint replacement reported? 

ANSWER

CPT code 27438, Arthroplasty, patella; with prosthesis, would be reported for the procedure performed regardless of whether 1 or 2 components were implanted. Please note that it would be inappropriate to report CPT code 27442, Arthroplasty, femoral condyles or tibial plateau(s), knee, separately as both procedures were performed in the same knee joint.


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