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Orthopedic Coding Alert

Reader Question:

Look For Bone and Tendon Replacement in Failed Quadriceps Mechanism

Question: Our surgeon did a right knee quadriceps reconstruction and inserted a new tibial polyethylene tray in a patient who had a failed right quadriceps mechanism of total knee. The operative note describes that our surgeon replaced the tendon and patella with a donor tendon and patella. Do we report this as a tendon transplant or a revision of total knee replacement? North Carolina SubscriberAnswer: The procedure sounds more like a quadriceps reconstruction. The term 'quadriceps mechanism' refers to the tendon of the quadriceps which has the patella embedded. 'Failed quadriceps mechanism' is not a very common complication that follows knee replacement surgery. The term implies that the quadriceps tendon is ripped off the tibial tubercle. There are two procedures here -- 1) revision of the tibial tray, and 2) reconstruction of the quadriceps mechanism. You report 27486 (Revision of total knee arthroplasty, with or without allograft; 1 component) -52 (Reduced [...]

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