# MCL, LCL, and MPFL Reconstruction



## CJoy0724 (Jun 9, 2010)

One of our physicians did arthroscopic ACL and PCL reconstructions, and Open MCL, LCL, and MPFL reconstructions.  He is wanting to code 29888, 29889, and 27427 x3.  Can we do this?  Since 27427 doesn't state "per ligament" doesn't that mean we can only bill it once per knee?  Any help would be great!
Thanks!!


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## wgore18 (Oct 12, 2020)

This is an old question, but I've recently been wondering the same thing as the original commenter. Both 27427 [extra-articular reconstruction, knee] and 27428 [intra-articular reconstruction, knee] have an MUE of 1. However, the only official guidance I could find with multiple billing of these codes was from CPT Assistant, April 2009 which advised the use of 27428 and 27428-59 when an open ACL and an open PCL reconstruction occurred during the same op session. Unfortunately, I haven't found much to offer regarding the extra-articular ligament reconstructions [ex. billing multiple units for separate reconstructions of the LCL and MCL].


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## Orthocoderpgu (Oct 12, 2020)

I've been on the lookout for the same information without success either. Currently 27427 has an MUE of one with an adjudication number two meaning "policy". If I remember right, policy edits means that you can't bill out more than the MUE even with records. I'll check that in the morning to verify that. That would mean that if multiple were done you could use -22, but not bill more units. **  This does have an MAI of "2" that this is a "policy" edit and those can't be appealed with medical records. So -22 it is.


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