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Orthopedic Coding Alert

Reader Questions:

Use -LT, -RT for Bilateral Knee Replacements

Question: Our surgeon recently performed bilateral total knee replacements at the same time. One orthopedic surgeon performed the right knee surgery while the other orthopedic surgeon performed the left knee arthroplasty. The patient is insured by Senior Blue. Which modifier should I use in this situation?

New York Subscriber

Answer: You should report 27447 (Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing [total knee arthroplasty]), with the site modifiers appended to denote each side:

Dr. A: Report 27447-LT (Left side)

Dr. B: Report 27447-RT (Right side). Remember to check with your payer before you report the -LT and -RT modifiers, because some insurers have individual preferences regarding how you should bill such claims.

You should report the charges to the insurer on separate claim forms because each surgeon's "signature" must appear at the bottom of his individual claim form. 

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