(2023) CPT 27447 | Description, Guidelines, Reimbursement, Modifiers & Examples
CPT 27447 can be reported for services when the physician performs arthroplasty of the knee, plateau, condyle, lateral and medial compartments with or without patella resurfacing (total knee arthroplasty). The physician performs total knee replacement surgery with artificial knee parts.
Description Of CPT 27447
The official description of CPT 27447 is: “Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty).”
The following are the reasons why total knee replacement surgery performs by the physician:
- Osteoarthritis is the inflammation of joints that occurs in 50 or older people.
- Rheumatoid arthritis: synovial membrane becomes thickened and inflamed around the joint.
- Post-traumatic arthritis may occur due to severe knee injury that leads to total knee replacement.
The Physician exchanges most knee joint, such as severely damaged or worn cartilage. He makes a small incision in the midline over the knee.
The physician replaces severely damaged or worn cartilage of the knee joint. A midline incision makes over the knee, and dissection exposes the knee joint. The physician may release soft tissues and ligaments to correct deformities and improve range of motion.
The physician uses a cutting-alignment jig placed on the upper tibia to remove the tibial joint surface (medial and lateral compartments) by making a bone cut. A cutting-alignment jig is also used on the femoral condyles to make the appropriate bone cut.
Depending on the integrity of the joint surface of the patella, the physician may also make a bone cut to remove damaged cartilage. If the joint surface is not healthy, it is only required; otherwise left intact.
The physician repairs the incision in layers with staples, sutures, or Steri-strips. The physician secures them with glue and or bone screws. Peg holes create by the physician, and the prosthesis components incorporate into the tibia, femur, and patella if needed.
Reimbursement
A maximum of one unit can be a bill on the same service date of CPT 27447. In contrast, the Two units allow documentation supporting the service’s medical necessity.
The cost and RUVS of CPT 27447 are $1400.35 and 40.46530 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 27447 are $1400.35 and 40.46530 when enacted in the non-facility.
Billing Guidelines
Documentation should support the medical necessity of service. It reflects that service is medically necessary and appropriate.
CPT 27447 includes medial and lateral compartments and reports for total knee replacement, and It is not appropriate to report sedately.
Suppose knee arthroplasty with medial or lateral compartment performs in addition to CPT 27447. In that case, reporting CPT code 27446 with modifier 59 is appropriate.
Suppose revision of a total knee arthroplasty performs in addition to CPT 27447. In that case, reporting CPT code 27487 with modifier 59 is appropriate.
Suppose revision of a total knee arthroplasty performs with one compartment in addition to CPT 27447. In that case, reporting CPT code 27486 with modifier 59 is appropriate.
Suppose removing a total knee prosthesis performs in addition to CPT 27447. In that case, reporting CPT code 27488 with modifier 59 is appropriate.
Billing Example
A 60-year-old female presents with knee pain for four days at the office. The pain gets worse with movement and when lying down. The patient took some medication for pain.
The physical exam revealed swelling in the knee region. The physician ordered a CT of the Knee, which showed degeneration of the knee joint. The patient also has effusion of both knees. The patient denies other symptoms, such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The physician consulted with orthopedics and suggested total knee arthroplasty. The physician scheduled the total Knee arthroplasty for next week, and he was prescribed medications for further treatment.
