Wiki knee spacer exchange

[paigehonerkamp@yahoo.com]

Patient underwent TKA, became infected and subsequently underwent removal of TKA with insertion of antibiotic spacer.
The patient is still infected, so doctor is planning an antibiotic spacer exchange. The patient is still in the global period.

Wanting thoughts on how people are coding this. We have used 27310 with 20704 and had it deny. I am wondering if
it would be more appropriate to bill unlisted and compared to revision CPT 27487 to reflect the work performed.

Any thoughts are appreciated!

 

[amyjph]

What was the reason the 27310 and 20704 denied? That seems to me how it should be coded when you are exchanging the spacer because the infection is not clear yet and the final implant can't go in.
When they did the first case where they removed the TKA and implanted the abx spacer, was that coded 27488?
I wouldn't use unlisted for the exchange.
These cases are difficult because the codes don't always fit.