Extraarticular reconstrction medial collateral ligament with Allograft and Medial reef
Performed small arthrotomy to examine the joint. I then found the femoral and tibial origins and insertions of the MCL. I placed guide wires into the approximate locations, tied a suture around then and then examined the knee to find the isometric point. This was determined. I marked the site on the tibial side. Drilled a hole for a interference fit. We sawed the semi tendinosis tendon, whipstitchedd it together, fastened it into the hole with screw. Then, on the femoral side, a deeper hole was drilled. I passed a Keith needle through and through, exiting on the lateral side well anterior. Then I used this to pull the whipstitched graft into position, held it tight, once again reexamined the knee. Graft was stable. I then fixed the graft into the tunnel with an interference screw. I then performed a medial advancement in the pants-over-vest fashion with the medial capsular structures, irrigated and closed in layers.
I want to use code 27427. Is that enough? The hospital coders also used code 27405, but I am not sure if that is appropriate to bill also. It is not bundled. Any help would be greatly appreciated.
Performed small arthrotomy to examine the joint. I then found the femoral and tibial origins and insertions of the MCL. I placed guide wires into the approximate locations, tied a suture around then and then examined the knee to find the isometric point. This was determined. I marked the site on the tibial side. Drilled a hole for a interference fit. We sawed the semi tendinosis tendon, whipstitchedd it together, fastened it into the hole with screw. Then, on the femoral side, a deeper hole was drilled. I passed a Keith needle through and through, exiting on the lateral side well anterior. Then I used this to pull the whipstitched graft into position, held it tight, once again reexamined the knee. Graft was stable. I then fixed the graft into the tunnel with an interference screw. I then performed a medial advancement in the pants-over-vest fashion with the medial capsular structures, irrigated and closed in layers.
I want to use code 27427. Is that enough? The hospital coders also used code 27405, but I am not sure if that is appropriate to bill also. It is not bundled. Any help would be greatly appreciated.