Wiki Medial reinforcement right knee w/lateral release.

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scooter1

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I am not sure with this. Patient had a total knee arthroplasty a couple months ago. Now surgeon is doing this procedure for maltracking patella. I am thinking 27422 27425, but seems like that is too much. Maybe should do just the 27425 ? Please help. All suggestions are appreciated.

"Went ahead and incised along the medial arthrotomy scar from superior to inferior pole of the patella. I then performed a lateral release with the knee in flexion. Once this was done, I then took three #2 Ethibond sutures and pulled the patella over medially as much as I could. The patella seemed to track nicely after I did this . I reinforced the suture closed with #1 Vicryl. Prior to closing the arthrotomy, the knee was bathed with betadine solution and saline."
Then he did the closure.
 
As described in his procedure, he really only did an Open Lateral Reticular Release (27425), which corrected the maltracking problem. He does not appear to have done enough in his medial retinacular repair with the knee in flexion and as tightly as possible after the Lateral Release, to fulfill the requirements for an Extensor Realignment Procedure (27422). He may balk at this and want more, but the documentation as presented only supports the Lateral Release.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 
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