Question: My orthopedist performed an unusual surgery of an arthroscopy and partial medial meniscectomy with an open distal tibia tubercle realignment and medial reefing. How should I bill this? Tennessee Subscriber Answer: Without including a diagnosis or information from your op note, you may not get the most accurate response. You might look at, however, the following codes: " 27420 (Reconstruction of dislocating patella; [e.g., Hauser type procedure]) or 27422 (& with extensor realignment and/or muscle advancement or release [e.g., Campbell, Goldwaite type procedure]), " 29881 (Arthroscopy, knee, surgical; with meniscectomy [medial OR lateral, including any meniscal shaving), " and 27418 (Anterior tibial tubercleplasty [e.g.,Maquet type procedure]) for the distal tibial tubercle realignment. These codes have no Correct Coding Initiative (CCI) bundles preventing you from reporting them together. Therefore, you do not need a modifier.