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  • Knee Arthroplasty Procedures – Anatomy of Coding September 2018

    September 2018

    While many coders are familiar with unicompartmental (UKA) and total (TKA) knee arthroplasty procedures there are a couple of different coding scenarios that may leave you scratching your head.

     

    Scenario #1

    The patient underwent a MEDIAL unicompartmental knee replacement five years ago.  Due to progressive ongoing degenerative symptoms the patient now presents for a LATERAL unicompartmental arthroplasty on the same knee.  This does not make the procedure a total knee or conversion to total knee arthroplasty.  This is sometimes referred to as a bi-unicompartmental arthroplasty representing a UKA in both the medial and lateral compartments and the new procedure should be reported with CPT code 27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment.

     

    Scenario #2

    When the patient has had a previous partial knee replacement (UKA) and presents for a revision procedure you should report 27599 Unlisted procedure; femur or knee because the only revision codes available are for “total” knee replacements.  This also applies to replacement of the tibial liner.  You would not report 27486 with modifier -52 because 27486 represents a revision of total knee arthroplasty.