# Quad tendon repair



## jmkitchen (Aug 11, 2009)

Wondering what CPT anyone uses for Quad Tendon Repair?


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## Bella Cullen (Aug 11, 2009)

I think your going to have to go with unlisted on that one. 27599


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## mbort (Aug 11, 2009)

The quad tendon attaches to the patella at one end and the other attaches to quad muscle. Where was the repair?

Look at 27385


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## jmkitchen (Aug 12, 2009)

"An anterior approach was undertaken of the knee through the old scar. Upon entering, we noted that the quadriceps tendon seemed to be ruptured. There was a clear opening right into the joint superior pole notch just retinacular. The quadriceps tendon had not retracted"
27385 states 'muscle' rupture.  Can it be used for a tendon also?


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## mbort (Aug 12, 2009)

unfortunately that note doesnt really say where it was torn.  I would query the surgeon to find out if it was at the muscle attachment or not.  If its at the muscle attachment, I would use the 27385, if not then I would use 27664.


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## jmkitchen (Aug 12, 2009)

Thank you for your help!  I'm looking in the right direction now


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## martnel (Aug 12, 2009)

This question was on the Orthopedic Practicum for the COSC exam, and the answer was 27664.


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## tincyr (Aug 19, 2009)

How can you use 27664? That is under the section for Leg (Tibia and Fibula) and Ankle Joint. A torn quadriceps tendon extends in the femur portion of the leg to the patella. Wrong body part! I go with the unlisted.


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## mbort (Aug 19, 2009)

tincyr said:


> How can you use 27664? That is under the section for Leg (Tibia and Fibula) and Ankle Joint. A torn quadriceps tendon extends in the femur portion of the leg to the patella. Wrong body part! I go with the unlisted.



Actually---if you read the lay description in the coder's desk reference, it states the following:
*The physician makes a midline, longitudinal incision to expose the damaged extensor tendon in the leg. The surgical site is irrigated and the torn ends of the tendon are realigned to provide for better attachment and brought together and sutured. The tendon may be attached to the retinaculum around the knee. *If the repair is secondary, significant scar tissue may be debrided, and a graft may be necessary. Any nonviable tissue is also removed. The physician repairs the tendon with sutures or by placing a graft and suturing. The graft may be secured to the area of repair with a screw. The physician irrigates the wound with antibiotic solution. The wound is closed in layers. A cast or splint may be applied. Primary repair is done immediately after injury. Secondary repair is done sometime after the incident of injury or following a previous surgical repair. Report 27664 for a primary repair without graft and 27665 for a secondary repair, with or without a graft.


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