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Orthopedic Coding Alert

Reader Questions:

Bill 20924 When Harvesting From Opposite Knee

Question: Do insurers include graft harvest in the ACL repair code 27407? Our surgeon made an anterior incision parallel to the tibia tubercle to harvest the gracilis tendon for a graft.

Delaware Subscriber

Answer: The American Academy of Orthopaedic Surgeons' Complete Global Service Data for Orthopaedic Surgery states that "harvesting and insertion of fascial, tendon, or bone graft" is bundled into 27407 (Repair, primary, torn ligament and/or capsule, knee; cruciate).

Therefore, you cannot report 20924 (Tendon graft, from a distance [e.g., palmaris, toe extensor, plantaris]) separately when the surgeon harvests the graft from the same knee.

If, however, the surgeon harvests the graft from the patient's opposite knee, most insurers will reimburse you for both 27407 and 20924.

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