Excision of patellar tendon ossicle with ORIF tibial tuberosity

Ccgerson

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Any help is appreciated. Thank you!

Procedure: Open-reduction and internal fixation RIGHT knee tibial tubercle
Excision of patellar tendon ossicle

I have 27540 for the ORIF tibial tubercle. I was looking at 3 codes for the excision of the ossicle. 27360 and 27380, 27347. 27331 is included in the 27540 code, and not sure if that's appropriate anyway since the ossicle wasn't 'loose' but had to be excised. Here's the portion of the OP note describing the ossicle excision.

"I then turned my attention to the intrapatellar tendon ossicle. I localized this fluoroscopically. I incised the patellar tendon in line with its fibers, identified and sharply removed the ossicle. Once this was complete I irrigated the wound with copious amounts of sterile saline with bacitracin. I closed the periosteum with #1 Vicryl suture in an interrupted fashion. I closed the patellar tendon in a running fashion with 1 Vicryl suture. I again irrigated the wound and closed the skin and subcutaneous tissue in a layered fashion with 2-0 Vicryl, 3-0 Vicryl and a running 3-0 Monocryl suture. I reinforced the inferior aspect of the incision with two 3-0 nylon horizontal mattress sutures. I reinforced the skin with Steri-Strips, dressed the wound with Xeroform and a dry sterile compressive dressing
 
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