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Wiki Intraop fracture during TKR

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aztekchic

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My physician did a TKR and in the process of inserting the trial components "the medial z retractor was inadvertenly placed intraosseously into a groove and in the process of flexing to intrerpret the femoral and tibial components the medial cortex of the medial femoral condyle sheared off with the MCL insertion. He does state that the patients bone quality was poor. He ended up doing an ORIF of the Medial Femoral Condyle. I am not sure if I can separately bill for this since the fracture occured from the physician during sugery. Any help would be greatly appreciated.
 
I would not code for both since the code for open treatment of femoral condyle fracture (CPT 27514) is included in the CCI edits for CPT code 27447. The only time it would be appropriate would be if the 27447 was for one knee and the 27514 was for the other knee. I would code for the 27447 only. Hope this helps.

Rhonda
 
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