# Medial collateral ligament repair - help please



## hencked (Dec 10, 2008)

Extraarticular reconstrction medial collateral ligament with Allograft and Medial reef

Performed small arthrotomy to examine the joint.  I then found the femoral and tibial origins and insertions of the MCL.  I placed guide wires into the approximate locations, tied a suture around then and then examined the knee to find the isometric point.  This was determined.  I marked the site on the tibial side.  Drilled a hole for a interference fit.  We sawed the semi tendinosis tendon, whipstitchedd it together, fastened it into the hole with screw.  Then, on the femoral side, a deeper hole was drilled.  I passed a Keith needle through and through, exiting on the lateral side well anterior.  Then I used this to pull the whipstitched graft into position, held it tight, once again reexamined the knee.  Graft was stable.  I then fixed the graft into the tunnel with an interference screw.  I then performed a medial advancement in the pants-over-vest fashion with the medial capsular structures, irrigated and closed in layers.

I want to use code 27427.  Is that enough?  The hospital coders also used code 27405, but I am not sure if that is appropriate to bill also.  It is not bundled.  Any help would be greatly appreciated.


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## PatriciaCPC (Dec 12, 2008)

I would use 27405 & 27422.


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