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Orthopedic Coding Alert

You Be the Coder: Medial Retinaculum

- Published on Mon, Jan 01, 2001 Updated on Wed, Oct 01, 2014
Reviewed on May 20, 2015
Question: What is the correct code for an open repair of the medial retinaculum? The diagnosis is traumatic disruption of the medial retinaculum s/p total knee arthroplasty.

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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

  Answer: CPT does not have a definitive code for an open repair of the medial retinaculum (the closest is 27425 lateral retinacular release any method). CPT states that if there is not a code that specifically identifies the procedure performed it is appropriate to use the unlisted procedure code. Since this procedure is performed on the knee 27599 (unlisted procedure femur or knee) would be appropriate. Whenever an unlisted procedure code is charged a copy of the operative report should be sent along with the claim form to ensure appropriate reimbursement.   "

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