Unicompartmental Knee to Total Knee
Need help!! Having a dispute between 27487-52 & 27447-22. Have a patient that had a medial unicompartmental knee arthroplasty done a few years ago. Now is having progression of arthrosis to the lateral & patellofemoral compartment. Dr. is removing the Oxford medial unicompartmental knee arthroplasty & converting to TKA. According to the AMA CPT assist from July 2013 27487-52 is a revision of someone that has already had a Total Knee Replacement. Dr. is inserting implants Depuy-Attune Size 4N femur, Size 3 tibia, Attune posterior stabilized polyethylene size 4/10 mm & attune medialized anatomic patella size 35mm. I found an article from AAOS October 2003 Bulletin Common coding questions & answers that says this normally would be coded 27487 the revision code includes the removal of old prosthesis, however depending upon documentation & the situation, this could also be coded 27447 & 27488-51. Goes on to include Note: This is not a revision of a TKR. Except for removal of a partial tibial tray & femoral metal runner, the procedure is the same work as a primary total knee. I know 27488 is a column 2 code so would only charge 27447. Am I misunderstanding these articles? To me this would be more work therefore I don't understand why we would use 27487-52. Margie or Ruby can you please help? Thanks in advance for anyone to help solve this problem.