Knee arthroplasty is considered the most successful procedure in all of medicine. Due to the success rate of the procedure, surgeons perform over 700,000 knee replacements in the United States each year.
Despite this procedure’s prevalence in the USA, most medical professionals still face challenges with its medical billing. To address your billing issues, we have prepared a comprehensive guide on CPT code 27447. This will provide major help in accurately billing and securing payments for this service. So let’s get started without a delay!
CPT Code 27447 – Description
27447 is the procedural code used to report total knee arthroplasty (TKA).
In this treatment, the orthopedic surgeon replaces the damaged weight-bearing surfaces of the knee joint’s medial and lateral compartments with metal or other durable implants. He may or may not use an implant to replace the patella. However, the goal of this surgery is to reduce severe knee pain and disability.
Appropriate Use Cases for CPT Code 27447
Here are a couple of real-world scenarios for code 27447.
Osteoarthritis
For our first scenario, imagine a 63-year-old woman who has had excruciating pain in her right knee for nearly five years. Two years ago, she received a diagnosis of advanced osteoarthritis. She was attempting anti-inflammatory drugs and physical therapy at the time to help with her knee problems.
But now, her orthopedic surgeon suggested a total knee replacement after talking about the poor results of conservative treatment and her deteriorating mobility. CPT code 27447 can be used to report the surgery because the specialist replaced both knee compartments.
Severe Knee Deformity
Lastly, consider a 67-year-old retired athlete whose joints have sustained widespread wear and strain over the years, resulting in a serious knee deformity. His knee alignment has gotten so bad that he feels severe discomfort with each stride and is prone to losing his balance.
His preliminary X-rays show that both compartments have extensive degeneration. To address the abnormality and alleviate pain, his orthopedic surgeon suggests a total knee replacement. CPT code 27447 is the proper code because the procedure entails replacing all of the knee’s key components.
Modifiers to Append with CPT Code 27447
The following are some modifiers that may be applied with 27447.
Modifier 50
Modifier 50 represents a bilateral procedure. You can apply this modifier with CPT code 27447 to indicate that the procedure was performed on both knees during the same operative session.
Modifier LT
Modifier LT is used with CPT 27447 to specify that the total knee arthroplasty was performed on the left knee.
Modifier RT
Modifier RT is used with code 27447 to specify that the total knee arthroplasty was performed on the right knee.
Reimbursement Guidelines for CPT Code 27447
Below are some guidelines regarding the documentation of CPT code 27447 and the global period of the service.
Include Proper Documentation
Documents are the major source of your reimbursements. The insurance payers require you to prove the medical necessity of the procedure, which is done via comprehensive paperwork. Furthermore, there is some other vital information that you must provide with the claim for CPT code 27447, such as:
- Patient’s detailed medical history.
- Reports from the physical examination and imaging tests.
- Mention the details like symptoms, functional limitations, and previous non-surgical treatments attempted.
- A discharge summary including any complications or post-operative care.
- Documented progress during the pre-operative and post-operative period.
- An operative report specifying the components implanted and any additional procedures performed.
Be Wary of the Global Days
The global period for this code is 90 days. This period involves pre-operative services on the day before surgery and post-operative care for the following 90 days.
The reason for this set period is that the total knee arthroplasty requires a variety of services by the surgeon, such as follow-up visits related to the surgery itself. So the payer will release a combined reimbursement for all the related services rendered within this period.
Final Thoughts on CPT Code 27447
In summary, CPT code 27447 is frequently utilized for knee replacement surgeries. We have discussed real-world examples in order to improve comprehension of this code. Moreover, we highlighted the applicable modifiers and informed you about the necessary paperwork and the global period of the code. You can use all this information to bill this code accurately.However, if there is even the slightest doubt, consider getting professional assistance. We advise you to use NeuraBill’s orthopedic billing services. Their billing specialists are accessible around the clock to resolve your medical billing issues.
