Darshna Posted Wed 08th of March, 2017 22:14:28 PM
My provider did below procedures, which cpt codes do I use?
1 Repair of Quadriceps Mechanism
2 Repair of extensor mechanism, including extensor retinaculum medial and lateral
3 Evacuation with removal of hematoma
4 irrigation and debridement of skin soft tissue and bone left knee
5 removal of loose body
6 complex closure of wound approximately 12 cm
SuperCoder Answered Thu 09th of March, 2017 02:32:22 AM
Greetings from SuperCoder.com!
Please find answers against each question asked by you:
- Repair of Quadriceps Mechanism - ANSWER: You should report either 27385 (Suture of quadriceps or hamstring muscle rupture; primary) or 27386 (Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft) depending on whether the surgeon performed a primary or secondary repair.
- Repair of extensor mechanism, including extensor retinaculum medial and lateral – ANSWER: Report either code 27664 (Repair, extensor tendon, leg primary, without graft, each tendon) or code 27665 (Repair, extensor tendon, leg secondary, with or without graft, each tendon) depending on whether the surgeon performed a primary or secondary repair.
- Evacuation with removal of hematoma – ANSWER: Report code 27301 (Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region) if removal of hematoma is performed from the thigh or knee region.
- irrigation and debridement of skin soft tissue and bone left knee – ANSWER: For this you should code it as debridement of bone, code 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less) because it includes debridement of all the three areas mentioned by you, i.e. skin, soft tissue, and bone.
- removal of loose body – ANSWER: If the loose body is removed arthroscopically from the knee then you should report code 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation))
- complex closure of wound approximately 12 cm – ANSWER: Choose you code from the following codes depending upon the area of closure:- 13120 (Repair, complex, scalp, arms, and/or legs 1.1 cm to 2.5 cm) or 13121 (Repair, complex, scalp, arms, and/or legs 2.6 cm to 7.5 cm). If the area of repair exceeds 7.5 cm, then you should report code 13122 (Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)) also. You may repeat code 13122 for each 5 cm until you get your area.
We have provided you the answers based on your limited documentation. Please correlate these with your medical records carefully and check CCI edits and other guidelines too for the combination of codes.
Please feel free to write if you have any concern or questions.