Wiki Total Knee Revision

[adunlap23]

I could use some guidance in coding the following procedure:

The doctor performed a total knee revision on just the patella and tibial insert.

From my understanding, the code 27486 is for one component (the femoral component OR the entire tibial component). In this instance, the tibial insert is not considered the entire tibial component and the patella is considered included in 27486. Would it be appropriate to bill 27486-52 for reduced services?

Any help would be appreciated!

 

[adunlap23]

No need for modifier-52. Since the procedure includes both the femoral component AND the tibial component, why not bill 27487?

He did not replace the femoral and tibial component. He only replaced the patella and part of the tibial component (the tibial insert). Cpt code 27487 specifies the "entire tibial component".
It's confusing, but per Codify's description, ctp code 27486 is for the revision of an entire tibial or femoral component. Thus, the patella does not count for this code and the doctor did not replace an entire tibial component. That's why I suggested the use of the reduced services modifier. Does that make sense?

 

[adunlap23]

Does anyone else have any experience with something like this?