AAPC - Back to school
Results 1 to 2 of 2

Thread: Total Knee with recession ACL

  1. #1
    Join Date
    Apr 2007
    Redding, CA

    Default Total Knee with recession ACL

    AAPC: Back to School
    I have never seen this one before, and I am new to Ortho, so if you can help, thank-you!

    Procedure Performed: Right total knee replacement with full lateral release of collateral ligaments, recession anterior cruciate ligament, and fractional lengthening of the iliotibial band, right knee.

    In the operative note, the doc states this: I first performed a release of the lateral collateral ligaments by a sub periosteal dissection over the lateral tibial tuberosity. I released the posterior capsule and elevated this off of the femur using an elevator. Then, this was still too tight. I recessed the posterior cruciate ligament off the femur. Again, it was still tight, and it seemed to be in the IT band. I then sectionally lengthened the IT band. At this point, the ligamentous balance was deemed quite good. I was able to use a 12mm, which resulted in appropriat tension medially. The knee flexed easily, but the extension was still lacking about 10 degrees passively. I had released the capsule, and therefore I felt this was likely just tightness in the hamstring musculature from many years of not straightening. Therefore, this was felt to be appropriate.

    This only demonstrates the part of the op note where I am not sure what to code, The remainder is a standard knee replacement.

    I know I need to use 27447, but I'm not sure which other codes to use? would I use a 27425 for the lateral release? And I have no idea on the others. Thanks for the help! I sincerely appreciate it!

  2. #2


    The Coder's Desk Reference says that "The physician may release soft tissues and/or ligaments in order to correct deformities and improve range of motion."

    I'd think an insurance company would call it inclusive...
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

Similar Threads

  1. Unicondylar knee to Total knee
    By scooter1 in forum Orthopaedics
    Replies: 2
    Last Post: 04-04-2012, 07:08 AM
  2. Total remove knee spacer insert total knee components
    By Mary Baierl in forum Orthopaedics
    Replies: 5
    Last Post: 02-22-2012, 06:59 AM
  3. Replies: 1
    Last Post: 12-03-2010, 05:46 AM
  4. Knee Surgery -acl
    By codedog in forum Outpatient Facilities
    Replies: 2
    Last Post: 08-06-2008, 08:37 AM
  5. UNI Knee Revised to Total Knee
    By Frosty in forum Orthopaedics
    Replies: 1
    Last Post: 06-12-2008, 10:28 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.