Polyethylene insertion

One of my doctors had performed a total knee replacement on a patient 3 weeks ago. The patient comes to the ER with joint infection. He takes the patient to the OR performs an arthrotomy with removal of only the polyethylene. He inserts an antibiotic spacer and wound vac for a week then takes the patient back to wash out the knee joint again and replace the polyethylene. I'm stumped as to what CPT code to use for the replacement of only the polyethylene. Would I use 27486 w/ 52? My only draw back with that is he's not removing and replacing it in the same visit. Or would I use an unlisted code?

Any help is GREATLY appreciated.


  • edited May 2017
    For the poly replacement I would use 27486-52, but since this patient just had the arthrotomy & poly removal one week ago, you'll also need the 58 modifier to show it is a staged procedure. 27486-58-52.
  • What diagnosis code should I use for 11981- insertion of the antibiotic
    spacer. I am getting
    rejections with just the DJD code.
  • They are using it as a precaution against infection for their Totals.
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