# mixed answers, opinions please!



## Bella Cullen (Aug 10, 2010)

Hello, 
I have seen mixed answers on here for quadriceps tendon repair. 
some people have said 27385 and some have said 27664 and some unlisted. 
Can I please ask for your opinions again on this to see what people think presently on this. 
Thank you, 
Bella


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## DOVERRED (Aug 10, 2010)

based on what little info is given....like27664 better than27385


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## jdemar (Aug 11, 2010)

I agree w 27664 based on the info provided, you state tendon, not muscle.


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## Colleen25 (Aug 11, 2010)

This article is from The Coding Institute, hope it helps!

Question: How should we report a quadriceps tendon repair? Should we use the infrapatellar tendon repair code (27380)? 

Alabama Subscriber

Answer: No. You should report either 27385 (Suture of quadriceps or hamstring muscle rupture; primary) or 27386 (... secondary reconstruction, including fascial or tendon graft) depending on whether the surgeon performed a primary or secondary repair.

You should only report 27380 (Suture of infrapatellar tendon; primary) if the orthopedist repaired the infrapatellar tendon. Not only is this correct coding, but it can increase your reimbursement because the quadriceps repair codes (27385 and 27386) reimburse slightly higher than 27380.


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## jdemar (Aug 11, 2010)

.....????....see AAPC post dated 08-19-09 by MBort page 63.


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## Bella Cullen (Aug 12, 2010)

Well my opinion is I agree with Colleen, because according to the AAOS dx 727.65 (quadriceps tendon rupture) is the dx linked with 27385. and for 27664 the only dx linked to that code is 727.68 for other tendons of foot and/or ankle, but the quadriceps tendon is located on the upper portion of your leg not the lower portion. I just think 27664 is more for tendons of the lower portion of your legs.
Thank you so much for your answers because I was confused on this but now I think I will stick with 27385 for this. Final answer...LOL.


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## preserene (Aug 15, 2010)

Quadriceps Tendon  and the Patellar ligament :
I hope a brief note about the anatomy will clear our doubt.
The Quadriceps femoris  (fourheaded femoral muscles) covers the main bulk  anterior aspects and sides of the femur and has four parts: Rectus femoris, vastus femoris,Vastus intermedius and Vastus medialis, the three vastus are separable only with difficulty.
 Quadriceps is the great extensor of the leg and all four combine to form a tendinous attachment to the tibia. The tendons of the all of them unite in the distal portion of the thigh to form a single strong broad “Quadriceps Tendon” and attach to the base of the patella, a sesamoid bone in the tendon , which in turn, is attached THROUGH the Patellar Ligament to the tibial tuberosity. However,  the PatellarLigament is considered the continuation of the Quadriceps Tendon in which the Petella is embedded. This patellar ligament is the place where we look for the ‘tendon reflex'. 
So the distal attachment of quad mucles through the quad tendon is Base of Patella and by patellar ligament to the tibial tuberosity. 
Having known this anatomy, now let us figure out where to place the Quadriceps Tendon repair Code.
Obviously not 27664 which is for  lower most extremity  is “leg”.
There is a Code for Suture of  Infrapatellar Tendon -27380.
The suture of quadriceps ( or hamstring ) Rupture ; Primary – 27385  This includes the muscular portion of quadriceps and the broad stumpy Q. Tendon, just above the  base of patella. So the infrapatellar “patellar Tendon is different  from  Quadriceps muscle & Q.Tendon, for coding purpose also.-
 ie to brief,  above the patella and below the patella tendons are coded with different code number ,
27385 and 27380 respectively.
Now you assign the code of your surgery!
Thank you for your patience!!
.


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## Bella Cullen (Aug 16, 2010)

preserene said:


> Quadriceps Tendon  and the Patellar ligament :
> I hope a brief note about the anatomy will clear our doubt.
> The Quadriceps femoris  (fourheaded femoral muscles) covers the main bulk  anterior aspects and sides of the femur and has four parts: Rectus femoris, vastus femoris,Vastus intermedius and Vastus medialis, the three vastus are separable only with difficulty.
> Quadriceps is the great extensor of the leg and all four combine to form a tendinous attachment to the tibia. The tendons of the all of them unite in the distal portion of the thigh to form a single strong broad “Quadriceps Tendon” and attach to the base of the patella, a sesamoid bone in the tendon , which in turn, is attached THROUGH the Patellar Ligament to the tibial tuberosity. However,  the PatellarLigament is considered the continuation of the Quadriceps Tendon in which the Petella is embedded. This patellar ligament is the place where we look for the ‘tendon reflex'.
> ...



Thank you for your time on this response and I appreciate all of the responses I've received. 
Happy Coding!!!


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