How To Use CPT Code 27488

CPT 27488 describes the removal of a prosthesis, including a total knee prosthesis, using methylmethacrylate with or without the insertion of a spacer in the knee joint. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27488?

CPT 27488 is used to describe the surgical procedure of removing a prosthesis in the knee joint. This may involve breaking the methylmethacrylate, a type of bone cement, and may or may not include the insertion of a spacer. The purpose of this procedure is to remove a loose or damaged prosthesis before it causes further harm to the joint.

2. Official Description

The official description of CPT code 27488 is: ‘Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee.’

3. Procedure

1. The provider begins by making an incision along the previous incision line on the knee.
2. After exposing the joint by moving the patella outward and removing the synovium, the provider locates and exposes the prosthesis to be removed.
3. The provider breaks the methylmethacrylate cement to dislodge or remove the prosthesis from the tibia or femur.
4. Using a surgical instrument, the provider removes the cement from the border of the implant.
5. If necessary, the provider may insert a spacer between the tibia and femur to prevent shortening of the extremity until a new prosthesis can be implanted.
6. The provider shapes bone cement to fit in the space between the tibia and femur.
7. The wound is irrigated with an antibiotic solution, and the provider closes the wound in layers. A drain may be left in place if needed.

4. Qualifying circumstances

CPT 27488 is performed on patients who have a loose or damaged prosthesis in the knee joint. This procedure is often done for patients with an infection or those who are not suitable candidates for a new prosthesis. The provider must ensure that the patient is appropriately prepped and anesthetized before performing the procedure.

5. When to use CPT code 27488

CPT code 27488 should be used when a provider performs the removal of a prosthesis in the knee joint, including a total knee prosthesis, using methylmethacrylate with or without the insertion of a spacer. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 27488, the provider must document the following information:

• Patient’s diagnosis and the need for prosthesis removal
• Details of the procedure, including the use of methylmethacrylate and whether a spacer was inserted
• Incision site and length
• Specific steps taken during the procedure
• Use of antibiotic solution for wound irrigation
• Closure method and any drains left in place

7. Billing guidelines

When billing for CPT 27488, ensure that the procedure meets the criteria described in the official description. It is important to accurately document the details of the procedure to support the billing. Additionally, be aware of any specific guidelines or requirements from insurance providers or Medicare.

8. Historical information

CPT 27488 was added to the Current Procedural Terminology system on January 1, 1990. It was initially listed as a non-inpatient procedure but was later added to the Inpatient Only (IPO) list in 2017. However, it was removed from the IPO list in 2021 and added back in 2022.

9. Examples

1. A patient with an infected knee prosthesis undergoes a procedure to remove the prosthesis using methylmethacrylate without the insertion of a spacer.
2. A patient who is not a suitable candidate for a new knee prosthesis undergoes a procedure to remove the existing prosthesis and insert a spacer using methylmethacrylate.
3. A patient with a loose knee prosthesis undergoes a procedure to remove the prosthesis and replace it with a spacer using methylmethacrylate.
4. A patient with a damaged knee prosthesis undergoes a procedure to remove the prosthesis without the insertion of a spacer using methylmethacrylate.
5. A patient with an infected knee prosthesis undergoes a procedure to remove the prosthesis and insert a spacer using methylmethacrylate.
6. A patient with a loose knee prosthesis undergoes a procedure to remove the prosthesis without the insertion of a spacer using methylmethacrylate.
7. A patient who is not a suitable candidate for a new knee prosthesis undergoes a procedure to remove the existing prosthesis and replace it with a spacer using methylmethacrylate.
8. A patient with a damaged knee prosthesis undergoes a procedure to remove the prosthesis and insert a spacer using methylmethacrylate.
9. A patient with an infected knee prosthesis undergoes a procedure to remove the prosthesis without the insertion of a spacer using methylmethacrylate.
10. A patient with a loose knee prosthesis undergoes a procedure to remove the prosthesis and insert a spacer using methylmethacrylate.