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Orthopedic Coding Alert

Reader Question:

Append Modifier -22 for Complex Uni-Arthroplasty

Published on Wed Mar 17, 2004

Question: Our physician performed a minimal-incision total knee uni-arthroplasty, but we can't find a CPT code that describes this service. Which code should we report?

South Carolina Subscriber Answer: You are correct -- CPT does not include a code that describes this procedure, but you can report the standard uni-arthroplasty code (27446, Arthroplasty, knee, condyle and plateau; medial OR lateral compartment).
 
If your surgeon appropriately documents an unusually complex surgery, you should append modifier -22 (Unusual procedural services) to the total knee replacement code. Ask the surgeon to also send the insurer a letter explaining why 27446 alone didn't describe the service.
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