Criteria not met
Diagnosis Code
M17.12 accepted
Pain Severity (Triad P1)
Moderate pain documented
ADL Documentation
No specific ADL limitations documented
Physical Exam (Triad P2)
No objective findings. ROM, crepitus, or effusion required.
Imaging (Triad P3)
K-L Grade 2 insufficient. Consider Rosenberg 45 deg flexion views.
PT Type
Formal in-person PT
PT Duration
0 weeks (requires ≥12 for standard patient)
Medications
No medication trial documented
Injection Timing
No recent injection
Contraindications
No absolute contraindications
Site of Service
Outpatient HOPD
Revenue at Risk
$19,281
Annual Impact (est.)
$289,215
Based on estimated annual procedures at current denial rates. Actual impact varies by volume and payer mix.
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Full Intelligence Report: CPT 27447
