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Arthroscopic MCL reconstruction w/allograft

  1. #1
    Smile Arthroscopic MCL reconstruction w/allograft
    Medical Coding Books
    I have been searching for the correct CPT for the above procedure, to no avail. Any assistance would be very much appreciated. Below is a scrubbed excerpt from the op note:

    Procedure performed:
    Right knee arthrospic ACL reconstruction with allograft---which is 29888
    Right knee medical collateral ligament reconstruction w/ allograft--?

    ...Once this was done, a subcutaneous dissection occurred from the area of the pes
    anserinus where incision had been made prior to the medial incision. A suture was placed around the Beath pin and to the area of the pes anserinus to show the correct isometry for the MCL implant. This was marked on the tibia. Next the femur at the medial epicondyle was then drilled with an acorn reamer to 25 mm. An Achilles tendon allograft was then used. The bone plug was placed in the medial epicondyle hole which was just reamed. Once this was done a bone interference screw from Mitek 7.5 mm x 25 mm was placed appropriately. Tension was placed on the Achilles tendon and showed good fixation. The Achilles tendon allograft was then subcutaneously to the area of the pes anserinus. This was brought just distal to the pes anserinus. A drill hole was then made in an anterior medial to lateral direction. Depth gauge was used and it showed a size of 56 mm. At this point in time a small slit was placed in the Achilles tendon allograft and a post with a spiked washer from Mitek was placed through the Achilles tendon allograft soft tissue and into the drill hole just distal to the pes anserinus. Tension was placed on the Achilles tendon during this time and there is slight varus of the knee. There was good fixation
    after the screw placement. After the surgery the patient had grade 1 Lachman and grade 1 MCL. The soft tissue was then copiously irrigated with normal saline. The tourniquet was let down. It showed no significant bleeding. The subcutaneous tissue was closed with 2-0 Vicryl sutures.

  2. #2
    Check out 27405 or 27427
    Stephanie Phillips, CPC-H

  3. #3
    For MCL reconstruction, use 27428 if open. Allograft is included

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