Orthopedic Coding Alert
Report Unlisted for Medial Retinaculum
Question: What is the correct code for an open repair of the medial retinaculum? The diagnosis is traumatic disruption of the medial retinaculum s/p total knee arthroplasty.
Texas Subscriber
Answer: CPT® does not have a definitive code for an open repair of the medial retinaculum (the closest is 27425, Lateral retinacular release, any method). CPT® states that if there is not a code that specifically identifies the procedure performed it is appropriate to use the unlisted procedure code. Since this procedure is performed on the knee 27599 (Unlisted procedure femur or knee) would be appropriate. Whenever an unlisted procedure code is charged a copy of the operative report should be sent along with the claim form to ensure appropriate reimbursement.
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