Orthopedic Coding Alert

Question: Our surgeon does quadriceps tendon reconstruction with patellar realignment. The diagnosis is re-rupture of lateral quadriceps tendon insertion. Is the patellar realignment included in code 27385 (Suture of quadriceps or hamstring muscle rupture; primary) or do we need another separate code for this? Colorado Subscriber Answer: Since the diagnosis here is a re-rupture of quadriceps tendon insertion, you are not correct to select the primary repair code 27385 for the repair of the quadriceps that your surgeon is doing. For a secondary rupture, you report code 27386 (Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft). The code is also a better choice since the term reconstruction here may imply that the rupture was old or more complex. You need to confirm with your surgeon or the operative note for the same. This code is inclusive of any fascial or tendon graft that may [...]