Wiki 2nd stage knee arthroplasty revision

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donsqueen

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Hi All,

I am not sure how to code the 2nd stage of a knee arthroplasty revision. Patient's prosthesis became infected and was removed during 1st surgery. He is now coming in for replacement again. I am considering 27487 with a modifier 52. Any thoughts?

Thanks in advance,

Amy
 
A 2-stage procedure
What happens when the surgery is not so straightforward and the procedure has to be done in stages? Assume a situation in which the surgeon removes a knee prosthesis and inserts cement or a prosthetic spacer at the time the implant is removed. If this procedure is performed outside the global period of the original surgery, it would be reported using code 27488—Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee.

Six weeks later, the same surgeon brings the patient back to the operating room to remove the spacer and replace it with the definitive knee prosthesis. This procedure would be reported using code 27447-58, 22—Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty).

Reporting either of these surgeries with the revision code 27487 would be incorrect because the CPT code that describes total knee revision surgery requires that the exchange to the definitive prosthesis be done in the same surgical session.
 
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