Orthopedic Coding Alert

Question: Our surgeon does quadriceps tendon reconstruction with patellar realignment. The diagnosis is re-rupture of lateral quadriceps tendon insertion. Is the patellar realignment included in code 27385 (Suture of quadriceps or hamstring muscle rupture; primary) or do we need another separate code for this?

Colorado Subscriber

Answer: Since the diagnosis here is a re-rupture of quadriceps tendon insertion, you are not correct to select the primary repair code 27385 for the repair of the quadriceps that your surgeon is doing. For a secondary rupture, you report code 27386 (Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft). The code is also a better choice since the term reconstruction here may imply that the rupture was old or more complex. You need to confirm with your surgeon or the operative note for the same. This code is inclusive of any fascial or tendon graft that may be needed in the repair. This code also is inclusive of the patellar realignment and you do not report another separate code for the same. However, more information is desired to make a reasonable code recommendation. The term 'patellar realignment' could indicate that the surgeon did a procedure consistent with code 27422 (Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release [e.g., Campbell, Goldwaite type procedure]).