1. Debra Ravenscroft
   Posted 3 months ago #
   

   Insurance company re-coding '27422' to '27427' I'm not understanding as physician states: The tendons were located, and using standard technique, the gracilis tendon was sharply harvested with a tendon strip. It was brought to the back table, cut to a 20-cm length and whip stitched on both ends by the physician's assistant. The patella was then prepared. There were two pins that were drilled parallel for Swivel lock anchors. These were slightly more superior due to a small medial inferior avulsion of the patella. The graft limbs were then positioned into the holes that were made by over drilling to 25 mm. They were secured with the Swivel lock anchors with excellent fixation. The guide was then brought over medially and using a lateral x-ray the anatomic position was noted for the medial pin which was drilled across and out the lateral side. This was over drilled with a 6-mm drill to the lateral cortex. The graft itself was then shuttled under the soft tissue bridge, loaded into the pin, and pulled out laterally.
   I'm being told since MPFL is extra-articular '27427' would be the proper code, I was wondering if you could help me understand the difference between the two codes.

2. SuperCoder
   Posted 3 months ago #
   

   As per this documentation, CPT 27422 is more appropriate than code 27427.

   In 27427, incision is done over the distal iliotibial band and it is incised and secured with screw and washer. So it is farther from the point.

   In 27422, incision is done anteromedially parallel to the quadriceps tendon and patella. As per documentation, "Two pins were slightly more superior due to a small medial inferior avulsion of the patella.” Therefore, CPT 27422 is relevant.

RSS feed for this Question