CPT 27446: Knee Arthroplasty, Unicompartmental
Arthroplasty, knee, condyle and plateau; medial OR lateral compartment. Partial knee replacement surgery replacing only the damaged compartment.
Why CPT 27446 Claims Get Denied
Claims billed under CPT 27446 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.
Prior authorization not obtained
Medical necessity not established — conservative treatment insufficient
Imaging does not support unicompartmental disease
Payer requires total knee replacement instead
Billing Tips for CPT 27446
Verify prior authorization requirements for major joint replacement. Document failure of conservative treatment. Imaging must show disease limited to one compartment. Medicare has specific criteria for joint replacement coverage.
Documentation Requirements
To support a clean claim for CPT 27446, your clinical documentation should include:
Prior authorization approval
Conservative treatment history (PT, injections, NSAIDs, bracing)
Weight-bearing X-rays showing unicompartmental disease
MRI if indicated
Operative report
Medical necessity letter
Common Modifiers for CPT 27446
Reduce CPT 27446 Denials by 60%
RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.