# Coding ACL reconstructions



## raidaste (Apr 13, 2016)

Since 29888 uses the arthroscope and 27407 also states that the arthroscope can be used for part of procedure, how do you determine which one should be used? 
My physician did a reconstruction on the ACL and used a tendon graft but I'm having a hard time deciding which procedure code to use. 
He used the arthroscope at the beginning to eval all the compartments and then he used it again while placing the guidewire in the center of the old ACL stump.

I've read so much stuff on this but it never really goes into detail. Any help would be appreciated.


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## Ravikirann (Apr 17, 2016)

Hi,

 You can use both 29888 and 27407 .This is for your reference. I hope it will help you.

Seven CPT® codes describe “arthroscopically aided” procedures. This means that even though part of the procedure is performed open, the arthroscopic procedure codes should be assigned. The codes are:
29850      Arthroscopically aided treatment of intercodylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851                      with internal or external fixation (includes arthroscopy)
29855      Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856                      bicondylar, includes internal fixation, when performed (includes arthroscopy)
29888      Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889      Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
29892      Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)

Thanks
Ravi


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## AlanPechacek (Apr 17, 2016)

*ACL Reconstruction*

For practical purposes, in this day and time, all ACL Reconstructions are done Arthroscopically (or Arthroscopically Assisted).  It is rare to do them "Open."  The Codes 24707 (repair) and 27427, 8, & 9 (reconstruction/augmentation, intra or extra-articular) are for open procedures.  29888 is for Arthroscopic (Assisted) Repairs/Reconstructions.  The Graft Harvesting, usually taken from the patient (autograft), is an open procedure, but is considered an integral part of the procedure and is not coded separately. 

Hopefully this will help clarify this for you.

Respectfully submitted, Alan Pechacek, M.D.


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