Qtr 1 Physician IRR 2017 MSK (Joint Surg) case study # 2
Aetna Medicare Ohio
68 year old male with prior authorization request for left total knee arthroplasty- cpt 27447.
The patient has been complaining of left knee pain for the last several years which affects ADLs. He has had a prior arthroscopic procedure in 2005.
Treatment has included more than 3 months of injections (steroid and viscosupplementation) and medications.
Other forms of treatment are not mentioned as having been performed or contraindicated.
Exam shows knee ROM from 3 to 100 degrees with crepitus and pain.
No BMI was provided.
X-rays show severe arthritic changes with complete loss of joint space medially and severe patellofemoral arthritis
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