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performing total knee replacement in the same hospitalization or shortly after.

Sandra Posted Tue 30th of March, 2010 15:00:02 PM

Pt had a total knee replacement and decided he would like to have the other side performed. If the tkr is done during the same hospitalization but different day do you get the full surgical allowable fee or is it cut in half because it is done in the same hospitalization? If the total knee replacements are done at the same OR time, do you only get 50 percent of the second tkr? Would appreciate it as I need to know that we got reimbursed correctly. Thanks you.

SuperCoder Answered Wed 31st of March, 2010 07:07:29 AM

No,there wont'nt be any problem in payement if total knee replacement is also performed on a diffrent knee. Only you need to add a modifier LT/RT. Payment criteria may vary in cases when this px would have been perfomed on both the knees on same date.

Sandra Posted Wed 31st of March, 2010 13:21:59 PM

Thank you. Will make sure that we added the modifiers. Thanks again

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