# Orif of avulsed tibial tubercle proximal tibia



## gsteeves (Apr 19, 2010)

Good Afternoon, 

Need some help with the following op note: 

An anterior knee incision was then made over the tibial tubercle. Dissection was taken down through the skin and subcutaneous tissues. Full thickness skin flaps were developed. The fracture was identified, irrigated and debrided of hematoma. Two cannulated screws were then placed across the fracture providing sound fixation. Distal to the fracture fragment was the avulsed patellar tendon which was secured to the degloved proximal tibia with a single suture anchor and two horizontal sutures with FiberWire. 

Thanks for your help, 
Gail Steeves, CPC


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## Frosty (Apr 19, 2010)

I think I would use 27540 "Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed".  As for the avulsed patellar tendon, 27380.  But I don't know that I would charge separately for the patellar tendon since it was part of the avulsion.  That makes more sense in my head, but I believe I would only use 27540.  I would ask your doc if he thinks this constitutes 2 separate surgeries.


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## gsteeves (Apr 20, 2010)

Thanks for your help!!


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