Wiki Revision Total knee (27487) "versus" Removal Knee prosthesis with insertion of temporary antibiotic prosthesis (27488), stage 1

[Newilkinson13]

I am needing help choosing the correct code for stage 1, either 27487 Revision total knee arthroplasty femoral and entire tibial components. Or 27488 Removal of prosthesis including total knee prosthesis with or without insertion of cement. Then once the infection is gone, then 27447,58, modifier if still in 90 day global. See below op note.

thank you,
nancy

 

[csardone]

27487 would be used for stage 1.
i'm confused what stage 2 is? You wouldn't bill another total knee when infection is gone. Total knee was already done.

 

[Newilkinson13]

Yes, total knee was done first. but over time the knee became infected because of the prosthesis. We removed the prosthesis 27488 (this is stage 1) and replaced it with an antibiotic spacer (implant type prosthesis). Patient is non weight baring, possibly limited to a walker or wheelchair until there is no sign of infection.
patient has the antibiotic implant type prosthesis removed and new components (prosthesis) put back in the knee, 27447,58,22. You wouldn't bill a revision code because the original components have already been removed and there is nothing to revise.