Open lysis of adhesions of right total knee arthroplasty
I am having difficulties finding the correct codes for this surgery. I would appreciate any help I can get.
1. Removal of hardware from right knee.
2. Open lysis of adhesions of right total knee arthroplasty.
3. Manipulation under anesthesia right knee.
PROCEDURE: The patient was identified in the preoperative
surgical area. Her right knee was marked with the surgeon's
initials. She was transferred to the operative suite by
Anesthesia. She underwent successful general endotracheal
anesthesia and was placed supine on the operating table. A
time-out was done to confirm the operative site. Consent was
confirmed. Her right leg was prepped and draped in the usual
sterile fashion. She did receive a dose of preoperative
antibiotics. Using the previous incision sharp dissection was
carried down to identify the retinaculum. I did perform a medial
patellar arthrotomy upon entering the knee. No gross purulence or
excessive fluid was encountered. There was heavy dense scar
tissue throughout the knee. The knee could only be ranged 30
degrees. We were able to identify the wire through a separate
lateral patellar arthrotomy. The knot was identified and the wire
was cut and easily removed. C-arm images confirmed that the
entire wire was removed in its entirety. Following removal of the
wire there was an immediate increase in range of motion to
approximately 60 degrees. Following this, manipulation under
anesthesia was performed and we were able to obtain flexion to
113 degrees with extension to 3 degrees. She did appear to have
appropriate stability of varus and valgus stress and her patella
did track normally. Following this we completed lysis of
adhesions and performed a synovectomy. We irrigated the
intra-articular portion of the knee with 3 liters of normal
saline using a pulse lavage system. Following this we closed the
retinacular with a PDS suture, subcutaneous tissues with Vicryl,
and the skin with staples. She was placed in standard sterile
dressings and successfully extubated by Anesthesia. She was
transferred to the postoperative recovery area in stable
I would code 27331.
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