How To Use CPT Code 27443

CPT 27443 describes the procedure for arthroplasty of the femoral condyles or tibial plateau(s) in the knee, which includes debridement and partial synovectomy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27443?

CPT 27443 is used to describe a surgical procedure that involves the reconstruction of defects in the femoral condyles or tibial plateaus of the knee. This procedure also includes debridement, which is the removal of damaged or unhealthy tissue, and a partial synovectomy, which is the excision of the defected or torn synovium. The purpose of this procedure is to relieve pain and improve the patient’s gait.

2. Official Description

The official description of CPT code 27443 is: ‘Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy.’

3. Procedure

1. The provider begins by making an incision around the margins of the knee joint after the patient is appropriately prepped and anesthetized.
2. They then remove the patella and excise the tibial and femoral ends to create space for the prosthesis.
3. For the reconstruction of the femoral condyles, the provider excises the distal femur and dissects the surrounding structures to regain the normal range of motion.
4. For the reconstruction of the tibial plateaus, the provider dissects the tibia along with the lateral and medial meniscus to regain normal range of motion.
5. The provider examines the synovium for any defects and excises the defected part, along with debriding any bony outgrowths.
6. They then drill holes into the tibia and thread the prosthesis through the holes, fixing it with screws or gum.
7. The prosthesis can either be cemented or noncemented.
8. The provider flushes the site with sterile saline, ensures hemostasis, and closes the incision with sutures in repair.

4. Qualifying circumstances

CPT 27443 is performed on patients who require the reconstruction of defects in the femoral condyles or tibial plateaus of the knee, along with debridement and partial synovectomy. This procedure is typically performed to relieve pain and improve the patient’s gait. It is important to note that this procedure is performed unilaterally, meaning it is performed on one knee. If the provider performs the procedure on both knees, modifiers 50, RT, and LT may be appended depending on payer preference.

5. When to use CPT code 27443

CPT code 27443 should be used when the provider performs arthroplasty of the femoral condyles or tibial plateau(s) in the knee, along with debridement and partial synovectomy. This code should not be used for other knee arthroplasty procedures that involve different components or techniques.

6. Documentation requirements

To support a claim for CPT 27443, the provider must document the following information:

• Patient’s diagnosis and the need for arthroplasty, debridement, and partial synovectomy
• Details of the procedure performed, including the specific structures involved and any complications encountered
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or services performed during the same operative session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27443, ensure that the procedure performed matches the description of the code. It is important to note that CPT code 27443 should not be reported with other knee arthroplasty codes, as it represents a specific procedure. Modifiers may be appended if the procedure is performed on both knees or if there are any specific payer requirements. It is also important to review the full range of codes that apply when performing knee arthroplasty to ensure accurate reporting.

8. Historical information

CPT code 27443 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes arthroplasty of the femoral condyles and partial synovectomy to relieve pain and improve their gait.
2. A provider performs debridement and partial synovectomy during arthroplasty of the tibial plateaus to address a patient’s knee condition.
3. During a knee surgery, a surgeon reconstructs the defects in the femoral condyles and performs a partial synovectomy to improve the patient’s knee function.
4. A patient with a knee injury undergoes arthroplasty of the femoral condyles and partial synovectomy to restore normal range of motion.
5. A provider performs debridement and partial synovectomy during arthroplasty of the tibial plateaus to alleviate the patient’s knee pain.
6. During a knee surgery, a surgeon reconstructs the defects in the femoral condyles and performs a partial synovectomy to address the patient’s knee instability.
7. A patient with a knee condition undergoes arthroplasty of the femoral condyles and partial synovectomy to improve their overall knee function.
8. A provider performs debridement and partial synovectomy during arthroplasty of the tibial plateaus to enhance the patient’s knee mobility.