Bone allograft to tibial and femur tunnels staged for future ACL reconstruction

jdibble

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Any ideas on the correct coding for this procedure would be greatly appreciated! I have searched for an answer in other threads but do not see a definitive answer! Someone out there must have had one of these surgeries!! If I have to use an unlisted code, then with what code would this be compared?

Postoperative Diagnosis
INSTABILITY RIGHT KNEE

Procedure Performed
Bone grafting of the femur and tibial tunnels as a stage procedure for future ACL reconstruction

Indications
Patient who has knee instability after having had a 2nd ACL revision. She was found be appropriate for removal of her previous allograft ACL and bone grafting of the femoral and tibial tunnels as a stage procedure for future ACL reconstruction. Risks benefits this procedure were discussed with the patient and her family preoperatively and informed consent was signed prior to the operation today.

The patient was taken operating room. The right lower extremity was prepped and draped in usual sterile manner after adequate anesthesia had been obtained. The the incision was made 1st over the tibial tunnel to remove the post and washer screw along with the interference screw. The screws were removed and the remaining graft was removed from the tibial tunnel using a rongeur and curette then the scope was placed into the knee joint through an anterior lateral portal. The graft was removed from the femoral tunnel using combination of shaver, Reamer, curette and rasp. After the tunnels were cleared of soft tissue back to bleeding bony walls then the bone graft was opened and thawed and prepared on the back table. A plastic syringe was used as a cannula to introduce the bone graft into the femoral tunnel using a dry socket method. The bone graft was packed in using a curette and bone tamp. Then attention was turned to the tibia and the tibia bone graft was inserted and packed in. With satisfactory fill of the tunnels with bone graft then the procedure was concluded. The incision sites were closed with 2-0 Vicryl suture and 3-0 nylon suture. Sterile dressings were applied and the patient was placed into a knee immobilizer and awakened from anesthesia and taken to the recovery room in stable condition.

Thanks for all responses!!
Jodi
 
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