Wiki Modified Lemaire procedure/knee

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Nelson

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Good morning,

Has anyone had any experience coding for a "Modified Lemaire" procedure in the knee? I have a note where the patient has a failed previous ACL reconstruction, a medial and lateral meniscus tear and this is what is being done (below). Would you code: 29881 (medial), 29882 (lateral), 29888-22 or 27599 (combine Lemaire w/ACL revision)?
Thanks. Kathy

PROCEDURE: Right ACL revision reconstruction with patellar tendon allograft, right arthroscopic partial medial meniscectomy, right arthroscopic transtibial posterolateral meniscus root repair, right iliotibial band tenodesis (modified Lemaire procedure).
 
Hi
I did some asking around, and got one of my experts to weigh in on your question. Please use this info only as a guide and consult with your payer before filing any claims. Thanks!
Best
Chris Boucher, MS, CPC
Senior Development Editor


ANSWER
"A modified Lemaire procedure is an extra-articular reconstruction performed to augment an ACL repair. It is reported with code 27427. According to AAQOS Codex, code 27427 may be reported in addition to code 27427. Individual payer guidelines may differ."
 
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I think AAOS was meant, not AAQOS. Correct me if I am mistaken. I'm not sure what code was meant to be billed with 27427 for the Lemaire. If the ACL repair was performed arthroscopically code 29888 bundles with 27427. If the ACL was performed open (27428) you can't bill both since 27427 & 27428 hit an edit since code 27429 would be billed for this combination. If the Lemaire procedure was performed to help support an ACL procedure, then code 27427 really would no be supported as it would not be a repair/augmentation of an extra-articular ligament. So at that point I think you would need to go unlisted with 29888 and use 27427 as the comparison code. Since 27427 bundles with 29888 the insurance could consider the Lemaire as bundled. This is too much thinking on a Monday morning.
 
Thank you! Our provider went with the unlisted 27599 as it was open and used 27427 as comparison.
 
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