2nd REQUEST

Lisa A

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Can someone please give me an idea of how to code for medial and lateral reticular tears? I have looked at 27428 but just not sure.

There was also a repair of the infrapatellar tendon. I am using 27380, is this right?

Any help is greatly appreciated!
 

PLAIDMAN

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I agree with the 27380 ( assuming it is primary)

There is not a code for repair of retinaculum, I usually use unlisted or find it is included in other procedures, very rarely have I seen ONLY the retinaculum torn usually I see it with other injuries that could be coded.

The retinaculum is just fibrous tissue that is holding tendons/ligaments in position they are supposed to be in. So usually you would repair a ligament and the retinaculum just goes along with the ligament, they are kind of attached/intermingled with each other.(that is not an official medical definition)

If the retinaculum is torn in an area different that the patellar tendon tear , I would have to recommend unlisted 27599.

Sorry hope that helps a little
 

jdemar

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Again, my favorite resource Orthopedic Decisions a service of Decision Health publication Feb. 2007, Vol.8, No.2; Both the quadriceps tendon and the medial retinaculum are considered components of the extensor mechanism of the knee, which also includes:
  1. the quadriceps muslce group
  2. patella
  3. patellar retinaculum
  4. patella ligament
  5. the lateral retinaculum, and
  6. adjacent soft tissue, according to anatomy reference books such as Wheeless' Textbook of Orthopaedics

The American Academy of Orthopaedic Surgeons states that 27385 includes the repair of the extensr.mechsm,since med/lat. retinac is part of that mechanism the code would also cover repair of the retinaculum. per Margie Scalley Vaught, consultant. I would x 2 or 59.
 

jdemar

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Yes, without the quad. they are all part of the mechanism. BUT I would additionally code the infrapatellar tendon, as the original question stated the patient also had 27380 (primary(assuming it was prim. and not 2ndry)) performed. That's my interpretation.
 

PLAIDMAN

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Sorry Lisa, I guess we can both check out reference material at decision health.

thanks jdemar! I am going to check it out.
 
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