Wiki Elbow collateral ligament reconstruction using allograft 24344 or 24343-22?

[kimmcelderry@gmail.com]

24344 Reconstruction states with tendon graft (including harvesting of graft)

Since CPT Assist 11/2019 states "Code 23552, Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft), should be reported because the code includes autograft or allograft tendon" Would this same logic apply to 24344 when using allograft?

Snip of op note: "Bone defect in capitellum was identified. Fibertak anchor was placed and semi T allograft was reduced to this bone defect. Allograft was then passed through the native ligament tissue and secured to the proximal ulna behind radial neck using another fibertak anchor. The allograft was then brought back and sutured to the isometric point using another fibertak anchor. This was done with elbow in 30 of flexion and forearm in pronation. Both the tendon limbs from proximal was then brought distal and secured to ulna using another fibertak anchor. Sutures from the first fibertak were also used to repair the native LUCL tissue and secured to the allograft too. Sutures from the isometric point were used to repair the common extensor origin. Sutures were tied together."

 

[NRaizman]

This can be coded 24344.
You are correct that either allograft or autograft can justify the use of this code. While there is some work associated with graft harvest, it's fairly minor. Most of the difference in work between 24344 and 24343 comes in the anchoring/tunneling/passing/securing of the allograft, whereas with "repair with local tissues" it's usually just suturing it down.

 

[kimmcelderry@gmail.com]

Thank you Dr. Raizman! That makes total sense.
Off topic but I just watched your AAOS webinar on Osteoporosis Fracture Care Coding and found it very informative thank you.

 

[NRaizman]

Thank you Dr. Raizman! That makes total sense.
Off topic but I just watched your AAOS webinar on Osteoporosis Fracture Care Coding and found it very informative thank you.

Thanks!

A topic for a separate thread, but there is lots of interest in the usage of PCM and CCM codes for this as well for Fracture Liaison Services to capture the non-face-to-face work of care coordination for bone health. I didn't cover that in the webinar, but I think it has to be a meaningful part of the strategy.