Orthopedic Coding Alert

Question: The orthopedist performed a left knee open bicompartmental arthroplasty, including PF and medial compartments. He also resurfaced the PF joint and medial compartment. How should we code a PF resurfacing with a medial arthroplasty?

West Virginia Subscriber

Answer: Based on this information, you could begin with 27446 (Arthroplasty, knee, condyle and plateau; medial or lateral compartment) for the arthroplasty and submit 27438 (Arthroplasty, patella; with prosthesis) for the resurfacing.

Mind the modifier: Correct Coding Initiative (CCI) edits list 27438 as a Column 2 code when paired with 27446, but you can report a modifier to distinguish between the services. Append modifier 59 (Distinct procedural service) to 27438 and include documentation supporting the claim for two services.