# Knee procedures



## nabernhardt (Nov 22, 2011)

ok here is what I have. non medicare pt
what I am needing help on is the open repair?
and if there is what could be bundled in?
OPERATION:
1. Right knee arthroscopy.
2. Medial plicotomy.   
3. Medial femoral condyle and patellofemoral chondroplasty.
4. Arthroscopically assisted lateral release.
5. Open medial retinacular repair.

29875, 29877 59, 29873, and 27422? (this is the one I am unsure of)

PROCEDURE: The patient was taken to the operating room, placed under general anesthesia.The limb was prepared with alcohol and DuraPrep, draped in several layers. The limb was exsanguinated, tourniquet was elevated. Lateral portals established. Grade 2 and 3 chondromalacia of the lateral ridge in the central aspect of the patella was identified and a chondroplasty was performed to a stable base. She had a rub lesion and a large plica medially. I clipped the plica and lightly débrided it and did a chondroplasty on the rub lesion. The rest of the chondral surfaces and the medial and lateral joint space and the meniscus were normal. Intracondylar notch structures in the lateral gutter were normal as well. After the chondroplasty and plicotomy, incised the lateral retinaculum through the lateral portal. That improved tracking considerably. I did an open medial retinacular repair, embrocating the medial patellofemoral ligament and its redundant structure by about 1 to 1.5 cm. I used multiple running locking embrocation sutures to a fresh bleeding base at the equator of the patella to augment the repair and then did a running suture on top of that to further secure it. Wound was irrigated and closed in two
layers. Portals were closed as well. 

any suggestions please?


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## TonyaMichelle (Nov 22, 2011)

29875 is listed as a separate procedure and can be used if unrelated or performed alone, this code is also a component of 29873.
29877 is a component of 29873 and a modifier is not allowed to override.
29873 is a component of 27422 and a modifier is allowed.

So I would use:

27422 (Reconstruction of dislocating patella; eg. Hauser type procedure).

29873 (Arthroscopy, knee, surgical; with lateral release) with modifier -51 for multiple procedures and -59 if the procedure was distinct or above and beyond the primary procedure.


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## nabernhardt (Nov 22, 2011)

thank you for your response.  I just have a question just trying to understand this a little bit.
couldn't I use 
27422 for the open repair
29877 for the chondroplasty 
and not the 29873 since it is a part of the 27422?

I am only asking if it would be better to do it this way or not?

thanks again


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## nabernhardt (Nov 22, 2011)

wait now I think I understand what you are saying
because the 29877 and 29875 are part of the 29873 and it is the more extensive procedure to use it alone with the 27422 and then I would have captured everything?


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