Q: I have a physician who performed a conversion of a patellofemoral joint to a total knee. He replaced the patellar polyethylene and implanted a total knee replacement. What would be the appropriate code for this? Would this be reported as 27447 or do we need to use a revision code or the unlisted code?
A: There isn’t a CPT code specific to conversion of a previous patellofemoral or unicompartmental arthroplasty to a total knee replacement. The AMA and American Academy of Orthopaedic Surgeons disagree about how these procedures should be reported.
The AMA states that a partial-to-total knee conversion should be reported with 27487 (Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component) appended with modifier 52 (Reduced services). (CPT Assistant, July 2013)

Q: I just want to make sure I understood you correctly a few minutes ago. Patient had a medial arthroplasty done last year but now comes in for the lateral side, this is coded as just another unicompartmental with CPT 27446 correct?
A: Yes, that is correct because it’s the opposite side of the knee.

Q: I am new to orthopedic coding and just curious if it matters the type of implant they are using such as ceramic, metal or any other material matter when I am choosing my code?
A: Welcome to Orthopedics! It typically does not matter. I say this based on today’s technology, which we all know can change next week. The only verbiage I would be concerned with is the Poly spacers which are different from the other pieces used during joint replacements.

Q: I thought 27132 was for anything but a THA. Confused.
A: Yes that is correct. Looking back at the poll question, I think I should have worded that a little differently.

Q: Is AAOS global surgery book a good reference? would you recommend it?
A: Yes I highly recommend using this resource to assist with orthopedic coding.

Mary Bort, CPC, CPMA, CANPC, CASCC, COSC

Mary Bort, CPC, CPMA, CANPC, CASCC, COSC

Consultant

Mary is a consultant for The Haugen Consulting Group with over 25 years of health care industry experience. She started her career in Orthopedics which was her passion for decades. In addition to Orthopedics, she provides expertise in other specialties such as Anesthesia, Ambulatory Surgery Center, as well as most surgical specialties . She has experience working the professional fee side of coding, audit, education as well as compliance, serving both coders and physicians, as well as the surgical side. She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Anesthesia Professional Coder (CANPC) Certified Ambulatory Surgery Center Coder (CASCC) and Certified Orthopedic Surgery Coder (COSC).

During her free time, she loves to do crafts, enjoys the outdoors, and the Broncos! She has 4 daughters, and 10 grandchildren which light up her life.

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