Outpatient Facility Coding Alert

Reader Question:

Think Outside the Joint for ALL Reconstructions

Published on Tue Aug 13, 2019

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Question: What CPT^® codes will I report for an anterior cruciate ligament (ACL) repair along with an anterolateral ligament (ALL) reconstruction. What about a medial meniscus repair with an ACL repair?

Utah Subscriber

Answer: For a CPT^® code that describes the ACL repair surgery, you will look no further than 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction). The ALL reconstruction surgery is a little more difficult to find. In order to determine the correct code, you must have a firm understanding of the difference between intra-articular ligaments and extra-articular ligaments. Simply put, an intra-articular ligament, such as the ACL, is a ligament inside the knee joint. The ALL, on the other hand, is an extra-articular ligament, which means it exists outside of the knee joint.

The CPT^® code you will use to report an ALL reconstruction is 27427 (Ligamentous reconstruction (augmentation), knee; extra-articular). However, you’ve got to be careful in reporting 29888 alongside 27427. Since the surgeon performs the ACL repair arthroscopically and the ALL reconstruction is an open procedure, National Correct Coding Initiative (NCCI, or CCI) edits will bundle 29888 into 27427.

On the other hand, you may report 29888 alongside 29882 (Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)). Unlike the ALL and ACL surgeries, ACL and medial or lateral meniscus repairs are often performed together arthroscopically. There is no NCCI edit between these two codes, which means you may bill for each respective service.