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  1. User id : 15936 Posted 2 years ago

    Would this be coded as 27380 or aq revision code?

    Patellar tendon rupture/inferior pole patella fracture, right knee revision
    arthroplasty.

    OPERATION PERFORMED:
    Primary repair of patellar tendon to the patella.

    INDICATIONS FOR OPERATION:
    Brief History: Pleasant 74-year-old who underwent a revision
    knee arthroplasty about 2 months prior. She fell about a week ago sustaining a
    small avulsion off the inferior pole of her patellar but more importantly
    complete rupture of her patellar tendon off the patella and loss of her
    extensor mechanism. She was brought to the operating room for definitive
    fixation.

    DESCRIPTION OF OPERATION:
    Incision was
    made midline in line with the patient's previous skin incision. Carefully
    dissected subcutaneous flaps. The patient basically, the patellar tendon
    avulsed off the inferior pole of the patella. There was just a small thumb
    nail size remnant but complete disruption of the extensor mechanism. There was
    also disruption of her retinaculum which had sort of retracted towards the
    midline posteriorly. The arthroplasty components were still well-fixed,
    especially the patellar component. We spent a lot of time carefully dissecting
    the tissue plane which was difficult at times. We mobilized the quad with
    finger and sharp dissection to break up adhesions. This allowed us to pull the
    patella distally nicely. We then used #2 FiberWire in a locking baseball type
    stitch through the patellar tendon remnant. This was done with 2 sutures.
    Drill holes were made in the patella and then these sutures passed through the
    drill holes. Tension was placed on the patella remnant and it was pulled
    distally as the sutures were tied, giving us a nice repair directly to bone.
    We had earlier freshened up the bone along the patella where the repair
    inserted. Again, we had already assessed the patellar polyethylene and that
    was stable. Next, we further repaired as best we could the retinacular tears.
    We were able to reapproximate the arthrotomy. All this was done with 0 Vicryl.
    Many sutures were placed in order to get as good of a repair and soft tissue
    mass as possible. The knee was irrigated throughout the procedure.

  2. SuperCoder Posted 2 years ago

    No need for a revision code. Earlier revised portions were mostly stable. The arthroplasty components were well-fixed. The avulsed part of the infrapatellar region was sutured only, so correct to code only 27380

  3. User id : 22576 Posted 2 years ago

    Can a Ambulatory surgical center bill for 27486 as this code states should be done inpatient.

  4. SuperCoder Posted 2 years ago

    CPT 27486 is not an ASC approved procedure

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  • Posted by 15936, 2 years ago. There are 4 posts. The latest reply is from .