Orthopedic Coding Alert

Question: Notes indicate that the orthopedist performed an arthroplasty on a patient’s left knee. How should I code this encounter?

Florida Subscriber

Answer: You don’t have enough information to make a wise choice about the proper CPT® code. Go back and check the notes for more information; hopefully, the provider has left you more clues than “left knee arthroplasty” there. Then, you should choose from one of the following codes, depending on encounter specifics:

• 27440 — Arthroplasty, knee, tibial plateau
• 27441 — … with debridement and partial synovectomy
• 27442 — Arthroplasty, femoral condyles or tibial plateau(s), knee
• 27443 — … with debridement and partial synovectomy
• 27445 — Arthroplasty, knee, hinge prosthesis (eg, Walldius type)
• 27446 — Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
• 27447 — … medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty).

Best bet: Unless you’ve missed something in the notes that makes absolutely clear which type of knee arthroplasty the provider performed, you’re probably going to need to ask the provider which type of knee arthroplasty he documented. It might not hurt to also let him know how many different knee arthroplasty codes there are, so this confusion doesn’t arise with the next knee arthroplasty patient.