Orthopedic Coding Alert

Some orthopedic surgeons use a computer navigation system during total knee replacement surgery, which you'll report with +20985 (Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less [List separately in addition to code for primary procedure]), says coder Carol Wilson. Some payers might deny reimbursement on the grounds that you're reporting an experimental procedure, but there's hope with other carriers.

Medicare, for example, will reimburse for +20985. CPT 2009 retired companion codes 20986 and 20987 in favor of reinstated Category III codes:

• +0054T -- Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images(List separately in addition to code for primary procedure)

• +0055T -- Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure).

Most coders find that getting reimbursed for Category III codes is a challenge. Be prepared to submit your claims with thorough documentation and know that even if your physician doesn't get paid, reporting the codes is essential for data collection regarding the service.