kzcoder
Networker
Hi,
I am wondering if this right quadriceps tendon repair should be coded as 27385 versus 27430? Are there any other repair codes that should be used?
A tourniquet was placed sterilely high on the right thigh. The limb was
exsanguinated and the thigh tourniquet was inflated. A longitudinal incision
was made extending from the quadriceps to the inferior pole of the patella.
The central tendon/rectus was noted to have avulsed close to the junction with
the patella, however, the remainder of the quadriceps had torn through
muscle. In particular, there was full thickness tear of the vastus medialis
extending all the way into the most medial edge. This was intrasubstance
occurring approximately 6 cm above the junction. The rectus tendon was
carefully mobilized. The distal stump was debrided of any nonviable tendon.
All prior hematoma was cleared. A bony trough was prepared in the proximal
pole of the patella using rongeurs and curet. Three longitudinal drill holes
were then made. Two #5 FiberWire sutures were then placed through the rectus
tendon in a running Krakow fashion. These were passed through the patella and
sutured over the bony bridges. The rectus was noted to be completely
approximated at this point.
Attention was turned to the remainder of the quadriceps. The anterior fascial
sleeve was repaired to the rectus using a combination of #5 and #2 FiberWire.
The muscle intrasubstance tears of the vastus medialis and lateralis were
reapproximated using a running #1 Ethibond. A deep fascial layer was brought
together with 0-Vicryl and the skin was reapproximated in standard layered
fashion. Meticulous hemostasis was obtained with the electrocautery device
prior to closure.
I am wondering if this right quadriceps tendon repair should be coded as 27385 versus 27430? Are there any other repair codes that should be used?
A tourniquet was placed sterilely high on the right thigh. The limb was
exsanguinated and the thigh tourniquet was inflated. A longitudinal incision
was made extending from the quadriceps to the inferior pole of the patella.
The central tendon/rectus was noted to have avulsed close to the junction with
the patella, however, the remainder of the quadriceps had torn through
muscle. In particular, there was full thickness tear of the vastus medialis
extending all the way into the most medial edge. This was intrasubstance
occurring approximately 6 cm above the junction. The rectus tendon was
carefully mobilized. The distal stump was debrided of any nonviable tendon.
All prior hematoma was cleared. A bony trough was prepared in the proximal
pole of the patella using rongeurs and curet. Three longitudinal drill holes
were then made. Two #5 FiberWire sutures were then placed through the rectus
tendon in a running Krakow fashion. These were passed through the patella and
sutured over the bony bridges. The rectus was noted to be completely
approximated at this point.
Attention was turned to the remainder of the quadriceps. The anterior fascial
sleeve was repaired to the rectus using a combination of #5 and #2 FiberWire.
The muscle intrasubstance tears of the vastus medialis and lateralis were
reapproximated using a running #1 Ethibond. A deep fascial layer was brought
together with 0-Vicryl and the skin was reapproximated in standard layered
fashion. Meticulous hemostasis was obtained with the electrocautery device
prior to closure.