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ALL reconstruction

Lynn Posted Wed 06th of July, 2016 10:39:44 AM
I need help finding the correct code to be used for right knee ALL reconstruction (Anterolateral Ligament Reconstruction) along with ACL reconstruction? This was done arthroscopically assisted. I have always heard that when both the intra and extra-articular ligaments were reconstructed at the same time that you must forgo the scope codes and code only the open code 27429. Is this true for the above case? Is the ALL an extra-articular ligament? Thank you for your advise.
SuperCoder Answered Thu 07th of July, 2016 02:54:51 AM
Hi, For the right knee arthroscopic revision of a previous ACL Repair (29888), and anterolateral ligament reconstruction (27427). But in the current case ALL repair is being done by arthroscopy, hence, we cannot assign CPT 27427. Thus, ALL repair by arthroscopy will codes 29999 (Unlisted procedure, arthroscopy), with modifier-51.The use of 29999 with listed procedures, even with a -51 modifier, might raise the ire of some carriers, especially Medicare. As far as Medicare is concerned, you only inserted the scope once. Once you get the scope in, as far as the carrier is concerned, the biggest part of the procedure is done. Please, refer to the following link for further clarification. https://www.supercoder.com/coding-newsletters/my-part-b-coding-alert/acl-reconstructions-expect-the-unexpected-with-acl-revision-article
https://www.supercoder.com/coding-newsletters/my-orthopedic-coding-alert/overcoming-problems-coding-multiple-knee-ligament-repairs-article

Hope this helps. Thanks

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