# ORIF Tibial eminence fracture / ACL avulsion



## Ccgerson (Apr 9, 2018)

I have 27540 for ORIF tibial eminence/ intercondylar spine.  But I'm not sure if 27428 for ACL repair of the avulsion is coded in addition.?

OP Note:
Open reduction internal fixation of tibial eminence fracture

A medial para-patellar incision was made approximately 8 cm long.  The patellar tendon was retracted with a Gelpi. Additional hoffa's fat pad was debrided.  The fracture fragment was elevated and fracture hematoma and fragments were removed. The fracture fragment was reduced while freeing the medial meniscus.  The fracture was reduced using a ball spike pusher.  The fracture was held in place with a threaded K-wire.  Fluoroscopic images were obtained to verify satisfactory fracture reduction in both the AP and lateral planes.  The anterior cruciate ligament was then sutured with #2 Fiberwire in a locking Krakow stitch with 2 sutures.  Attention was then turned to creating 2 tibial bone tunnels with the anterior cruciate ligament guide with a beath pin through the tibia and fracture fragment.  The 4 tails from the sutures were passed through the tunnels and the sutures were tied over a button and bone bridge at 30 deg of knee extension with an posterior drawer applied.  Final fluoroscopic images showed satisfactory fracture reduction in both the AP and lateral planes. 

Thank you,
Cindy


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## Orthocoderpgu (Apr 9, 2018)

*You should bill both*

In looking at edits and AAOS, I don't see anything that would indicate that the procedures are bundled.


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