Orthopedic Coding Alert

Question: Our surgeon plans to perform an arthroscopy and a liner exchange of a previous total knee replacement. We were planning to report 27486-52 but we aren't sure whether it's correct. Which CPT code should we report for this service?


Texas Subscriber


Answer: You have two choices in this instance. Your first option is to report 27486-52 (Revision of total knee arthroplasty, with or without allograft; one component; reduced services). This code applies because the surgeon is revising part of the tibial component (the liner) while retaining the existing tray.

Your second option is to report 27599 (Unlisted procedure, femur or knee) for the surgeon's work performing the liner exchange.

In either case, you should submit the surgeon's op report with your claim, along with a letter from the surgeon explaining what he performed and how much reimbursement he requests for the procedure.