MPFL Reconstruction

The Surgeon has billed MPFL reconstruction as 27422.  I am thinking that this should be 27427 instead but I am unsure as to which is correct and how to tell him that why he has chosen the wrong code if 27422 is incorrect--t--they seem very similar.  Below is what was done:

At that point the scope was removed.  We focused our attention on the reconstruction.  Made a 4 cm incision over the anterior medial aspect of the distal femur.  We dissected down we took the Mimi medial fascia off the superior aspect of the patella.  We were able to expose the lateral aspect of the patella without issue.  We reamed with a 7 mm Reamer with the between the superior and middle 1 thirds centrally. We then isolated the medial femoral condyle.  Slightly anterior and on did the distal to the most extreme point we placed a guide pin and reamed to 30 mm.  Then used a had a passing pin past the is suture in the in the hamstring was brought as a loop into this distal femur.  We tapped and seated the 7 x 23 Milagro screw excellent purchase.  We brought the graft below the fascia medial but outside the capsule. We pay careful attention to the tension of the graft.  Full range of motion was noted on the table.  With the lateral least we did not need over tension the graft.  We used suture shuttle to pass the sutures through the knee after the been carefully measured and cut. We then tied over a bony bridge laterally with excellent fixation.  Upon tracking of the knee it was noted be excellent. At that point the knee was copiously irrigated.  We closed the retinaculum on the medial side adjacent to the patella as well as distal femoral condyle.  We then went down to layer 1 on the anterior medial sitting layer 1 was closed.  All skin incisions were closed.

Any help is greatly appreciated!!

Comments

  • Per an AMA inquiry MPFL reconstruction with autograft is coded to 27427. 
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