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Coding insights: Total Joint Arthroplasty

Paul Cadorette, CPC, COC, CPC-P, COSC, CASCC, Director, Training and Education, Coding

Register today for the Total Joint Arthroplasty Coding Webinar presented by Paul Cadorette on Tuesday, June 20th at 1pm CT.

Accurate coding is the cornerstone of successful revenue management for Ambulatory Surgery Centers (ASCs), especially when it comes to Total Joint Arthroplasty procedures. The correct utilization of CPT codes, ICD-10 codes, and modifiers is vital for precise reporting and timely reimbursement.

Don’t miss nimble’s upcoming Total Joint Arthroplasty Coding Webinar, where I’ll provide you with essential insights into coding techniques, modifiers, documentation requirements, and common coding pitfalls to avoid.

This webinar is your opportunity to enhance your coding proficiency, earn CEUs, and stay up to date with the latest coding guidelines to ensure optimal performance for your revenue cycle.

Join me on Tuesday, June 20th at 1:00pm Central as we uncover key coding insights in this specialized area.

What is total joint arthroplasty? 

Total Joint Arthroplasty (TJA), also known as joint replacement surgery, involves the replacement of damaged or diseased joints with artificial ones.

When it comes to TJA replacement procedures, the codes are fairly consistent in that each anatomical section includes codes for insertion, removal, and revision services.

In this blog post, I’ll discuss some key coding considerations for TJA procedures that will be covered in greater depth during the webinar.

Understanding total joint arthroplasty procedures  

Total joint arthroplasty procedures include hip replacements, knee replacements, shoulder replacements, and ankle replacements. The type of procedure and the reason for the procedure will determine what codes should be used.  

For example, patients with previous hip surgery in their surgical history may require a conversion to total hip arthroplasty. Reporting the appropriate CPT code (27132) is crucial in such cases.

However, it’s important to note that this does not include patients who have already undergone a total hip arthroplasty or arthroscopic procedures.

The Role of Modifier -52

There are some variations in the code sets such as conversion hip, fractures with prosthetic replacement, reduced services (modifier -52), and use of unlisted CPT codes based on the actual services being performed.

Modifier -52 is typically used when replacing the poly component of a prosthetic device. This modifier may also be appended when converting a hemiarthroplasty to total joint arthroplasty in the knee.

Unlisted CPT Codes for Unique Services

Certain services performed during TJA procedures may not have specific CPT codes available. In such cases, reporting an unlisted CPT code becomes necessary. Two examples are patellofemoral arthroplasty and focal resurfacing implants. There are no specific CPT codes available to describe a patellofemoral arthroplasty procedure. This is because such procedures involve unique anatomical considerations. Additionally, focal resurfacing implants, which aim to replace damaged cartilage without removing bone or using prosthetic components, also do not have dedicated CPT codes.

Unlisted codes highlight why it’s important to have consistent documentation for each procedure. The patient’s medical record should include the reason for the TJA procedure, plus any preoperative evaluations and postoperative care, including physical therapy.   

Join the webinar for in-depth coding insight 

If you’re eager to dive deeper into the world of coding for total joint arthroplasty, I invite you to join our upcoming webinar to receive an in-depth analysis of coding techniques and strategies.  

This webinar is also an opportunity to receive AAPC continuing education units. You’ll be able to interact, ask questions, and further enhance your coding proficiency. 

Webinar Details 

Title: Total Joint Arthroplasty

Date: Tuesday, June 20

Time: 1:00pm Central Time

Duration: 1 hour

Register here:

I hope this blog post has given you a glimpse into the intricacies of TJA coding.

Remember to join our upcoming webinar for a more in-depth exploration of TJA coding techniques and strategies that will strengthen your coding skills.  Register today.

About the Author

Paul Cadorette is an accomplished professional in the field of medical coding, serving as nimble’s Director of Training and Education. With a passion for education and extensive experience, Paul provides comprehensive training and resources to ASC coding professionals, helping them navigate the complexities of medical coding and revenue cycle management. His deep understanding of coding guidelines, documentation requirements, and best practices, particularly in the specialized area of total joint arthroplasty, enables him to deliver authoritative insights and practical recommendations. With a reputation for effectively translating complex coding concepts, Paul is dedicated to empowering coding professionals to enhance their coding skills and optimize revenue cycle outcomes, ensuring accurate reimbursement in an ever-changing healthcare landscape. 

Are you looking for ways to improve your revenue cycle management? Take the first step towards optimizing your revenue cycle process by requesting a revenue assessment from our team of RCM experts. Request a demo.

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