# Total Knee Replacement w/Removal of prior Total Knee Prosthesis



## IRISHCODER (Dec 2, 2010)

This is my first encounter with this issue. Our new knee surgeon performed a total knee replacement due to a periprosthetic supracondylar femur fracture. He also performed a Posterior Capsulotomy due to a flexion contracture. He had to remove the existing knee hardware before he could perform the replacement or capsulotomy. Does anyone know if the removal of existing hardware is bundled or separately billable? I see in the CCI edits it allows for a modifier, but is this situation sufficient (periprosthetic femur fracture) to allow for the use of the modifier? Also, the flexion contracture caused the procedure to be more difficult and time consuming. Would it be separately billable or would you append a 22 to the primary procedure? 
I appreciate any advice you could give me! Hopefully after a few of these I'll be more familiar with knee surgeries! Thanks


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## kathydaniel (Dec 3, 2010)

When hardware is removed to put in new, then you can't bill for the removal.  It's included in the "reinsertion".


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