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Old 07-17-2009, 07:59 AM
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Red face Repair retinacular tears knee cpt?

Hello coders, what code is used for repair of medial and lateral retinacular tears of the knee? The quadiceps tendon was repaired at the same time and I have code 27385 for that but I can't find a code for other procedure. The facility coder used 27403 but I was looking at the 27405-27409 codes. Any ideas? Thanks, Paula in Dublin, Ohio

1. Repair left knee quadriceps tendon. 27385
2. Repair left knee medial retinacular tear.
3. Repair left knee lateral retinacular tear.

PROCEDURE
A standard midline incision was
made over the patella and quadriceps tendon. Sharp dissection was taken
with a scalpel through skin. Blunt retractors were placed in the wound,
and all hemostasis obtained throughout the case with Bovie. Tenotomy
scissors were used to bluntly dissect down to the rupture. The hematoma
was evacuated. I could see in his joint, and he also had some
patellofemoral chondromalacia. The knee was irrigated out. He also had
tears of the medial and lateral retinaculum. The quadriceps tendon was
freshened with a rongeur. Three #2 FiberWire sutures were used to whip
stitch the tendon. I then cleaned off the insertion of the superior
pole. This was done with a rongeur. I then drilled 4 holes through the
insertion from superior to inferior. I used a Hewson suture passer. I
passed the sutures through the tunnels in the patella with the Hewson
suture passer, passing the FiberWire sutures in the appropriate holes.
We put the knee in extension and tied down the sutures. This repaired
the quadriceps tendon down anatomically. The sutures were then cut. I
repaired the medial and lateral retinaculum with FiberWire which was
oversewn with a #1 Vicryl. The knee was let to bend down to 90 degrees,
and this had excellent repair. The knee was extended. Deep tissue was
closed with 0 Vicryl. Skin was approximated with 2-0 Vicryl then
staples were placed on the skin.
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Old 07-22-2009, 10:32 AM
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Hello coders, would it be possible to use code 27557 for the ligament repair? It is treatment of knee dislocation with primary ligamentous repair. Any thoughts, feedback? Thanks, Paula
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