Orthopedic Coding Alert
Reader Question:
Distal Tubercle Transfer
Published on Thu Mar 01, 2001
Question: One of our physicians performed a distal tubercle transfer medially (Elmslie-Trillat procedure) and an open medial patellofemoral ligament imbrication. For the Elmslie-Trillat, 27420 (reconstruction of dislocating patella; [e.g., Hauser type procedure]) seems appropriate, and for the open medial patellofemoral ligament imbrication 27422 seems appropriate. But 27420 is bundled with 27422, so we end up only using 27422. Is this correct coding?
Ohio Subscriber
Answer: With so many acronyms used to describe reconstruction procedures for recurrent patellar dislocations, it is easy to get confused. An Elmslie-Trillat procedure includes the following components: lateral retinacular release, medial capsular reefing (which your surgeons describe as medial patellofemoral ligament imbrication) and medial displacement of the infrapatellar tendon insertion. Appropriate coding selection for this procedure is 27422 (reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release [e.g., Campbell, Goldwaite type procedure]). No additional code would be reported for the lateral retinacular release because this is a component part of 27422 according to the American Academy of Orthopaedic Surgeons Complete Global Service Data for Orthopaedic Surgery.
Ohio Subscriber
Answer: With so many acronyms used to describe reconstruction procedures for recurrent patellar dislocations, it is easy to get confused. An Elmslie-Trillat procedure includes the following components: lateral retinacular release, medial capsular reefing (which your surgeons describe as medial patellofemoral ligament imbrication) and medial displacement of the infrapatellar tendon insertion. Appropriate coding selection for this procedure is 27422 (reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release [e.g., Campbell, Goldwaite type procedure]). No additional code would be reported for the lateral retinacular release because this is a component part of 27422 according to the American Academy of Orthopaedic Surgeons Complete Global Service Data for Orthopaedic Surgery.
Other Articles in this issue of
Orthopedic Coding Alert
- Use Modifiers -57 and -25 to Optimize Office Visits that Lead to Surger
When an orthopedist decides that a patient needs an immediate or near-immediate surgical procedure, coders [...] - Use Proper Documentation to Ensure Payment for Arthroscopic SLAP Repairs
Orthopedic coders often express frustration with coding for arthroscopic superior labrum anterior/posterior repairs, commonly known [...] - News Brief:
HCFA Temporarily Suspends Part of CCI Version 6.3
HCFA has temporarily suspended many of the edits in version 6.3 of the national Correct [...] - Letter Helps SLAP
The following letter to carriers describing the SLAP lesion repair and asking for reimbursement is [...] - You Be the Coder:
Total Knee Replacement
Question: My surgeon is scheduling more bilateral total knee replacements (TKR), and we have a [...] - Reader Question:
Multiple Injuries
Question: I treated a patient for the following:
1. Fracture care of left hand original [...] - Reader Question:
Physiatrist
Question: My practice just hired a physiatrist and Im at a loss as how to [...] - Reader Question:
Distal Tubercle Transfer
Question: One of our physicians performed a distal tubercle transfer medially (Elmslie-Trillat procedure) and an [...] - Reader Question:
Biopsy
Question: I am having trouble getting paid when a biopsy is done in the same [...] - Reader Question:
Hemi-arthroplasty
Question: The patient underwent a hemi-arthroplasty for a fractured hip. He returned to the nursing [...] - Reader Question:
Removal of Exostosis
Question: How do I code for removal of exostosis on the hip?
Utah Subscriber
Answer: [...] - Reader Question:
Assistant Surgeon Fees
Question: When billing for assistant surgeons fees, should I charge full price for the assistant, [...] - Reader Question:
Marcaine
Question: I am having difficulty getting paid for Marcaine. We use the unlisted HCPCS code [...] - Reader Question:
HCFA Scrutinizes 99214
Question: I have heard that Medicare is taking a closer look at claims for 99214. [...]
View All
