Orthopedic Coding Alert

Question: Our surgeon performed bilateral total knee arthroplasties. He operated on the left knee with a physician assistant assisting him. Then another physician (Dr. Jones) performed the right knee replacement, with our physician assisting. Both Dr. Jones and my physician wrote separate operative reports. Which codes should each physician report? They are not members of the same practice.

Washington Subscriber

Answer: Your physician should report 27447-LT (Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing [total knee arthroplasty]; Left side) for the left knee, and the assisting PA should report 27447-AS-LT (Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery; Left side).

Regarding the right knee, Dr. Jones should report 27447-RT, and your physician should bill 27447-80-RT. Modifier 80 (Assistant surgeon) tells the insurer that your surgeon acted as Dr. Jones- -extra set of hands.-

 -- Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.