AHA Coding Clinic® for HCPCS - 2021 Quarter 3; In this Issue
Knee arthroplasty procedures
A patient with a previous partial lateral knee replacement (uni-compartmental) developed arthritis in the medial compartment of the patellofemoral joint in addition to collapse of the medial and lateral aspect of the tibia. As a result, she presented for a conversion of a partial knee to total knee arthroplasty. The knee was entered via the previous incision. Osteophytes were removed off the medial femoral condoyle, the undersurface of the patella was resected, and the metal femoral component was removed. Bone was resected from the distal femur. Next, the tibial implant was removed and bone was resected from the medial aspect of the proximal tibia. This created a flat surface of the tibia. Trial components were placed, followed by placement and cementing of a short stem tibial component down an intramedullary canal for placement. The femoral component and patellar button were then placed and cemented into place. How is the revision from a previous uni-compartmental knee arthroplasty (UKA) to a total knee arthroplasty (TKA) reported? ...
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Article Overview
This article provides a broad overview of knee arthroplasty procedures for coding and outpatient facility reporting. It explains the clinical context for total and partial knee replacement, summarizes CMS outpatient and ASC policy changes affecting these services, and discusses associated CPT and HCPCS code reporting for primary procedures, revisions, and computer-assisted navigation. The content is geared toward professionals who need to understand how these procedure categories are organized and which code sets are involved.
Why This Topic Matters
Knee arthroplasty services are increasingly performed outside the inpatient setting, so accurate code-set awareness matters for facility and professional reporting. The article is useful for coders, billers, and outpatient facility staff who need a high-level understanding of the procedure categories and related coding framework.
Article Sections
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CMS outpatient and ASC policy context
Introduces recent CMS changes affecting where knee arthroplasty services may be performed. Provides the policy backdrop for outpatient facility reporting and Medicare beneficiary care settings.
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Knee anatomy and arthroplasty overview
Summarizes basic knee anatomy and describes the general concept of knee replacement surgery. Establishes the procedural framework used later in the article.
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Total knee arthroplasty
Reviews the general components and structure of total knee replacement procedures. Connects the clinical procedure category to the relevant coding discussion.
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Partial knee arthroplasty
Describes unicompartmental knee replacement concepts and the major partial replacement categories. Presents the coding framework associated with partial procedures.
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Revisions to knee arthroplasty
Covers reasons revision procedures may be needed and the broad types of revision operations discussed in the article. Includes the coding context for revision services.
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Computer-assisted navigation
Explains computer-assisted navigation in the setting of knee arthroplasty and outlines the major navigation categories. Reviews the related add-on coding framework.
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Questions and answers
Presents practical coding questions drawn from reported scenarios. Uses case-based discussion to illustrate how the article’s procedure categories are applied.
What You Will Learn
- How knee arthroplasty services are organized into total, partial, and revision categories
- What outpatient and ambulatory surgery center policy changes affected knee arthroplasty reporting
- Which code sets are associated with primary arthroplasty, revision, and computer-assisted navigation services
- How computer-assisted navigation is grouped into major categories in the article
- What kinds of practical coding questions commonly arise for knee arthroplasty procedures
Who Should Read This
- Medical coders
- Outpatient facility coders
- Hospital billing staff
- Physician coding staff
- Revenue cycle professionals
- Orthopedic practice staff
Codes Discussed
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