Coding Guidance-Makoplasty Robotic Assistance

 Makoplasty Robotic Assistance: Coding Clinic for HCPCS, Second Quarter 2020: Page 10

Coding advice contained in this issue is effective with procedures/services provided after May 20, 2020, unless otherwise noted.

Question: A patient presented for a total knee arthroplasty using Mako robotic assistance. The Mako arrays were secured to the half pins placed in the medial femoral condyles and proximal medial tibia. Once cutting parameters were set, the Mako robotic arm was brought in and bony resections were performed. Once the knee was trialed, the flexion-extension gaps were determined to be symmetric according to the Mako. The tibial plate was aligned with the Mako plan and the implant was placed. What code is assigned for a Makoplasty or Mako robotic assistance when performed with a knee arthroplasty?

Answer: Based on the documentation submitted, assign CPT code 0055T, Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure), for the Mako robotic assistance in addition to CPT code 27447, Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty), for the total knee arthroplasty.

The Mako system starts with a CT scan of the joint which is then utilized to create a 3D model. This model is then used during the surgical procedure to assist the placement and alignment of the implant based upon the patient's individual anatomy. When computer assisted musculoskeletal navigational procedures or services with CT or MRI are performed with arthroplasty, add-on code 0055T would be reported once.