Qtr 1 Physician IRR 2017 MSK (Joint Surg) case study # 1
AETKY-PPO Commercial
56 year old male with prior authorization request for Left TKA cpt 27447.
Member has severe left knee pain with ADL limiting pain for over 2 years and has modified his physical activities. He has had prior steroid injections and has a history of a prior arthroscopic surgery on the left knee.
He was started on naproxen by PCP 6 months ago and has attended PT but could not complete the program due to increased pain in the knee. He has also continued on a home exercise program.
Physical examination revealed Left knee ROM 10-95 degrees with tenderness, crepitation and a joint effusion. His BMI is 34.97.
Standing xrays show bone on bone articulation of the medial compartment with osteophytes around the patella which is tilting laterally on sunrise view.
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