# Arthrotomy-knee w/scar tissue removal



## kibbit99 (Jan 26, 2010)

Hello,

I had a question......Thanks in advance!

Dr. did an arthrotomy on the knee (Dx dislocated patella due to fall).  He removed scar tissue and did a lateral retinacular release.  Pt had TKR 1 yr ago.

Does CPT 27331 cover scar tissue, or is loose body different?  I am thinking it is not for scar tissue.  

CPT 27425 covers the release, but it will bundle with arthrotomy.  Long story short, how would code this?

PROCEDURE:  The knee was entered.  There was some normal-looking joint fluid that was observed.  Cultures were obtained in the operating room.  Significant amount of scar tissue was noted around the patella itself and in the suprapatellar pouch area.  The scar tissue was excised.  The implant was inspected and felt to be resonable alignment.  A lateral retinacular release was performed with a Bovie.  With removal of scar tissue, the patella could easily be brought past the normal notch medially.  It was decided that after the lateral release the knee would simply vest-over-pants or release the medial capsule to solve teh problem of the lateral subluxation of the patella. A #2 nonabsorbable suture was used along with #1 Vicryl to vest-over-pants or release the medial capsule of the knee.Knee was checked and the patella was centered in the trochlear groove at that time.


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