Monday, June 17, 2024
HomeReplacementCpt Code For Total Knee Replacement

Cpt Code For Total Knee Replacement

Definitions For Primary Revision And Conversion Codes

Total Knee Replacement Surgery (Arthroplasty) – University of Vermont Medical Center, Vermont

Hip and knee arthroplasty procedures have been under scrutiny by both Medicare Administrative Contractors and Recovery Audit Contractors. Although the primary concern has been adequate documentation of medical necessity, accurate coding of primary, revision, and conversion arthroplasty procedures is also important. This article addresses the definitions associated with primary, revision, and conversion arthroplasty procedures and codes specific to hip and knee arthroplasty procedures.

Procedure CodesTable 1 lists the CPT codes that define primary total hip and knee arthroplasty procedures, revision hip and knee procedures, and conversion to total hip arthroplasty. Note that there is no CPT code for a conversion to total knee arthroplasty.

Table 2 lists the procedure code that may be reported when treating an infected joint. The three codes cover the insertion of an antibiotic-impregnated cement spacer , its removal , and the exchange .

CPT code 11981 should be reported with CPT code 27091 or CPT code 27488 when the implant is removed and an antibiotic-impregnated cement spacer is placed. CPT code 11982 should be reported for the second staged procedure, when the implant is removed and a conversion to either a total hip arthroplasty or a total knee arthroplasty is performed.

DefinitionsThe following definitions describe the terms integral to selecting the appropriate arthroplasty procedure code, especially for revisions or conversions.

  • Document the global period dates.
  • Ceramic Femoral Prosthesis In Total Knee Arthroplasty

    The authors stated that by systematically reviewing these single-armed studies, they found that ceramic components could be used in the TKA procedure, with excellent long-term joint function and survival. However, because of the limited use of ceramic TKA components worldwide, RCTs and cohort studies comparing the long-term clinical results and survival between ceramic TKA components and conventional cobalt-chromium prostheses were not available. This may jeopardize the strength of this conclusion. These researchers stated that more research on ceramic TKA components, especially comparative studies with a higher level of evidence, are needed to support the use of ceramic components in the TKA procedure.

    Who Is Affected By Osteoarthritis

    Approximately 80% of older adults, ages 55 years and older, have evidence of osteoarthritis on X-ray. Of these, an estimated 60% experience symptoms. It is estimated that 240 million adults worldwide have symptomatic osteoarthritis, including more than 30 million U.S. adults. Post-menopausal women have an increased incidence of knee osteoarthritis compared to men.

    Recommended Reading: How Long Does It Take To Recover From Knee Replacement

    Customized Unicompartmental Knee Arthroplasty

    Fitz described the surgical technique with a patient-specific resurfacing uni-compartmental knee arthroplasty . The patient-specific implant is currently designed on the basis of data from pre-operative computed tomography . The implant is provided with a set of patient-specific, disposable cutting jigs. Biomechanical and anatomic axes are factored into jigs from a scan obtained through the hip, knee, and ankle, effectively achieving pre-navigation of the cut planes without the need for a navigation system. The surgical technique is reduced to 5 simple, reproducible steps. After removing the articular cartilage, the knee is balanced to determine the correct amount of tibial resection this is followed by femoral preparation, verification of balancing and tibial preparation, and trial and cementing of the implant. The introduction of personalized three-dimensional image-derived resurfacing implants, as well as personalized single-use instrumentation, has the potential to change the common surgical practice of uni-compartmental knee arthroplasty. Patient-specific resurfacing implants enable a femoral bone-preserving approach and enhance cortical bone support on the tibia, overcoming critical design limitations of commercial off-the-shelf implants. The author concluded that patient-specific resurfacing implants can restore normal anatomy, the position of the joint line, and normal joint function, with the potential to result in more normal knee kinematics.

    How Long Does It Take To Walk Normally After Hip Surgery

    Cool Diagnosis Code For Total Knee Replacement

    Most hip replacement patients are able to walk within the same day or next day of surgery, most can resume normal routine activities within the first 3 to 6 weeks of their total hip replacement recovery. Once light activity becomes possible, its important to incorporate healthy exercise into your recovery program.

    Recommended Reading: Treatment Of Arthritis In Knees

    American Hospital Association Disclaimer

    The American Hospital Association has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

    What Is The Icd 10 Code For Total Knee Replacement

    The ICD-10 code for total knee replacement is T86.21. This code is used to describe a procedure in which the knee joint is replaced with an artificial implant. This procedure is typically performed to relieve pain and improve function in patients who have arthritis or other conditions that damage the knee joint.

    In the United States, there are currently over 600,000 total knee replacement surgeries performed each year, and the number is expected to reach 1,272,000 by 2025. Coders and billers use ICD-10 codes to record a patients journey from pain and mobility issues to diagnosis insight and treatment after surgery. The global joint replacement market is expected to reach $16.6 billion by 2020, accounting for a 46% revenue share of the total market. Following total knee replacement surgery, physical therapy has been identified as a treatment protocol that can help patients improve their outcomes. ICD-10 coding tools assist in the efficient collection of knee replacement physical therapy bills. Outpatient physical therapy billing and practice management can be streamlined and reimbursed more effectively if an electronic medical record and billing software are used. Net Health Therapy for Clinics EHR streamlines ICD-10 coding and other billing/compliance procedures, allowing clinics to focus on patient care rather than compliance. As a result of success, office morale and staff retention rise.

    Recommended Reading: Is Tylenol Good For Knee Pain

    Revision Total Hip Arthroplasty Cpt

    A revision total hip arthroplasty is a surgery to correct a previous hip replacement that has failed. This surgery may be needed if the artificial hip joint has become loose, is causing pain, or has broken. The goal of the revision surgery is to relieve pain, improve function, and improve the patients quality of life.

    Non-critical orthopaedic procedures, which were postponed as a result of COVID-19, have resumed. When compared to standard hip replacement surgery, revision hip replacement is a more complicated procedure. The primary hip implant may be unable to replace the damaged bone and soft tissue surrounding the hip when a revision hip replacement is required. Bone growth on press-fit components that used to be firmly attached to the bone can be erratic. A loosening or lengthening of the plastic liner between the ball and metal cup can cause a painful hip. Tiny particles that wear away at the plastic liner of a cup can accumulate around the hip joint and cause immune system problems. Hip replacement involves the same ball-and-socket structure as your natural hip.

    It is possible to develop infection following revision surgery in comparison to total hip replacement surgery. To assist you after discharge, you will most likely require some assistance at home for several days to a couple of weeks. Almost all revision surgery patients have positive long-term outcomes after the surgery. There may be patients who still experience pain or dysfunction after revision surgery.

    Does Arthritis In The Knee Go Away

    Total Knee Replacement Surgery (Knee Arthroplasty)

    Mild morning stiffness is common in osteoarthritis and often goes away after just a few minutes of activity. Sometimes people with osteoarthritis also notice the same type of stiffness during the day after resting the joint for an hour or so. In rheumatoid arthritis, however, morning stiffness doesnt begin to improve for an hour or longer.

    Read Also: What Causes Severe Knee Pain At Night

    Bilateral Primary Osteoarthritis Of Knee

      20162017201820192020202120222023Billable/Specific Code
    • M17.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
    • The 2023 edition of ICD-10-CM M17.0 became effective on October 1, 2022.
    • This is the American ICD-10-CM version of M17.0 other international versions of ICD-10 M17.0 may differ.
    • Applicable To annotations, or

    License For Use Of Physicians’ Current Procedural Terminology Fourth Edition

    End User Point and Click Amendment:CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved . CPT is a trademark of the American Medical Association .

    You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services . You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

    Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site, .

    Read Also: How To Get Swelling Down After Knee Surgery

    What Is The Icd 10 Code For Hip Replacement

    ICD-10-CM Code for Presence of artificial hip joint Z96.64.

    What is the ICD 10 code for total hip replacement?

    Presence of artificial hip joint, bilateral

    Z96.643 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

    How do you code a hip replacement?

    Coding for the hip replacement surgery is 27132.

    What is the ICD 10 code for History of left hip replacement?


    What is the ICD 10 code for aftercare following joint replacement?

    ICD-10: Z47.1, Aftercare following surgery for joint replacement.

    What Cpt Code Is 27447

    Webpt Icd 10 Code For R Total Knee Replacement

    CPT® code 27447 deals with knee and condyle issues as well as plateaus.

    CMS has published an update to the codes for catheter drainage, guide wire, and catheter drainage. There are multiple applications for which these codes are used under the Catheters for Multiple Applications category. The use of catheters, drainage tubes, and guide wires can be used for a wide range of medical applications, including urinary tract infections and cancer treatment. Devices and systems that are used in a variety of applications are included in this category. The updated codes for the HHS/HCPCS system will assist physicians and patients in better understanding how various medical devices and systems work. The goal of this initiative is to improve patient care while lowering the cost of these devices and systems.

    Also Check: Why Do People Need Knee Replacements

    Knee Arthroplasty Cpt Codes

    Knee joint is subdivided into three compartments, medial , lateral and patellofemoral . UKA is performed in one of the knee compartments in which the damaged parts of the knee are replaced. This minimally invasive partial knee replacement may be an option for patients whose arthritis is isolated to either the medial or the lateral compartment of the knee. It is called a partial replacement because only one compartment of the damaged knee is replaced. This typically involves damaged joint or bone tissue in the knee joint, which is replaced with a man-made prosthetic, while the anterior and posterior cruciate ligaments are preserved. The incision for a partial replacement is smaller because of the smaller implants. In addition, UKA may result in less postoperative pain and a shorter recovery period than a TKA because there is less dissection, and therefore, less surgery is required. Although a UKA is less common than a TKA, the physician may recommend it as a more appropriate procedure for the patient because only one compartment of the knee is affected.

    Knee joint arthroplasty includes cpt code 27437-27447, 27486, 27487.

    27486 Revision of total knee arthroplasty, with or without allograft 1 component27487 femoral and entire tibial component

    Treatment For Left Knee Pain

    Treatments will vary, depending upon what exactly is causing your knee pain. Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout. Strengthening the muscles around your knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain. In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include corticosteroids, hyaluronic acid, and PRP. If you have an injury that may require surgery, its usually not necessary to have the operation immediately. If you choose to have surgery, your options may include arthroscopic surgery, partial knee replacement surgery, or total knee replacement.

    The table below includes the most commonly used ICD-10 codes for left knee pain:

    ICD-10 Chapter

    You May Like: What Are The Best Exercises For Bad Knees

    Cpt Code For Total Knee Arthroplasty Description

    Knee Replacement Arthroplasty is effective and medically necessary in some circumstances. The surgeon enters the CPT code for Total Knee Arthroplasty 27486 to revise total knee arthroplasty. Treatment for an infected joint procedure code is an insertion , removal , and replacement of an antibiotic-impregnated cement spacer are all covered by these three codes .

    All types of hip and knee arthroplasty procedures, including primary, revision, and conversion to total hip arthroplasty, are described by the CTP code. There is no CPT code for a complete knee arthroplasty conversion.

    In addition to restoring joint function, a common replacement procedure can help alleviate discomfort. Pain and dysfunction in the joints can persist despite the best efforts of drugs and physical therapy.

    As the name suggests, knee arthroplasty is a surgical process in which a damaged knee may replace. Typically affects middle-aged and older people and can lead to knee joint cartilage and bone degeneration. Several metal components cover the ends of the bones that make up the knee joint and the kneecap.

    The knee can be affected by a variety of rheumatoid arthritis. Part of the knee is replaced in one of the compartments by a technique called UKA . Those with knee arthritis in the anterior or posterior components may benefit from this less invasive total knee replacement procedure.

    Not to improve or maximize any payers compensation. All of the codes provided are for the same purpose.

    What Is Unilateral Primary Osteoarthritis Left Knee

    Bilateral Total Knee Replacement with Mikey Mike 12 days Post Operation TKR Sports Quick Recovery

    What is unilateral primary osteoarthritis left knee? Osteoarthritis is a common form of arthritis that often affects the knee. In the first stage, symptoms are mild, but by the fourth, a person may need surgery. Osteoarthritis of the knee affects the bones, the cartilage, and the synovium in the knee joint.

    Read Also: Do Shoe Inserts Help With Knee Pain

    How Do You Code Inflammatory Arthritis

    Inflammatory polyarthropathyM06. 4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.The 2022 edition of ICD-10-CM M06. 4 became effective on October 1, 2021.This is the American ICD-10-CM version of M06. 4 other international versions of ICD-10 M06.

    Dont Miss: Why Does My Knee Keep Popping

    Other Mechanical Complication Of Internal Left Hip Prosthesis Initial Encounter

      20162017201820192020202120222023Billable/Specific Code
    • T84.091A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
    • Short description: Mech compl of internal left hip prosthesis, init encntr
    • The 2023 edition of ICD-10-CM T84.091A became effective on October 1, 2022.
    • This is the American ICD-10-CM version of T84.091A other international versions of ICD-10 T84.091A may differ.
    • Applicable To annotations, or

    Don’t Miss: How Often Can You Get Knee Injections

    Implant Loosening And Wear

    In order for a total knee replacement to function properly, an implant must remain firmly attached to the bone. During the initial surgery, the implant was either cemented into the bone or press-fit to allow bone to grow onto the surface of the implant. In either case, the implant was firmly fixed. Over time, however, an implant may loosen from the underlying bone, causing the knee to become painful.

    The cause of loosening is not always clear, but high-impact activities, excessive body weight, and wear of the plastic spacer between the two metal components of the implant are all factors that may contribute. Also, patients who are younger when they undergo the initial knee replacement may “outlive” the life expectancy of their artificial knee. For these patients, there is a higher long-term risk that revision surgery will be needed due to loosening or wear.

    In some cases, tiny particles that wear off the plastic spacer accumulate around the joint and are attacked by the body’s immune system. This immune response also attacks the healthy bone around the implant, leading to a condition called osteolysis. In osteolysis, the bone around the implant deteriorates, making the implant loose or unstable. Advances in material science and plastic quality have made osteolysis less common today than in past decades.

    Osteolysis has occurred around the tibial component, causing it to become loosened from the bone .

    Dislocation Of Total Knee Replacement

    Effects of Total Knee and Hip Arthroplasty on Body Weight

    My doctor did a closed reduction of a dislocated total knee replacement. Should I use the unlisted procedure or am I missing a code for this?Beth

    0 Votes – to vote or reply. Report Abuse

    closed reduction knee post arthroplasty

    Hi BethUnlike the hip, there is no specific CPT code differentiating the management of the knee dislocation independent of the knee arthroplasty.There are 2 CPT codes you must consider27550 Closed treatment of knee dislocation without anesthesia 27555 Closed treatment of knee dislocation requiring anesthesia Remember, if this is a complication, patient is Medicare and in the global period, the patient must be returned to an operative suite to report this procedure.Mary LeGrand, RN, MA,CCS-P, CPCKarenZupko & Associates, Inc. Visit for more information on national coding courses sponsored byAAOS ,ACS AAOHNS , ASPS ,SVS , AANS and presented by KarenZupko & Associates,Inc. KZA also provides ASC coding assistance.

    0 Votes – to vote or reply. Report Abuse

    Recommended Reading: How Many Times Can You Have Knee Replacement Surgery


    Popular Articles