Wiki CPT codes for Patella orif w/ extensor mech reconstruction and medial and lateral retinacular repairs

[smfrickl]

I'm struggling with finding codes for the extensor mechanism reconstruction and the medial and lateral retinacular repairs. Any suggestions, please?

Pre-operative Diagnosis(es): Left comminuted and displaced inferior pole patella fracture and suspected retinacular disruption Post-operative Diagnosis(es):Same as above

Procedure(s) Performed: Left patella open reduction and internal fixation with extensor mechanism reconstruction Left knee medial and lateral retinacular repair

DETAILS OF THE OPERATION:The patient was met in the preoperative holding area, and the correct extremity was marked in conjunction with the patient. The patient was taken back to the operating room and placed under anesthesia. Pre-operative antibiotics were given. The left lower extremity was gently suspended a tourniquet placed on the thigh, and the extremity was thoroughly prepped and draped in a standard sterile fashion. Surgical time out was performed. Esmarch was utilized to exsanguinate the extremity and the tourniquet inflated. A midline incision to the knee was marked out. Incision was made through the skin and subcutaneous tissue dissection taken down to the retinaculum. The fracture was encountered, and there is noted to be a traumatic disruption of the medial and lateral retinaculum. The inferior pole fracture was identified and it was noted that it was comminuted and as expected there was inadequate bone for isolated bony fixation for reconstruction of the patella. 3 tunnels were drilled vertically in the body of the patella. Two FiberWire sutures were passed through the inferior pole fragments down the patellar tendon and back using a running and locking technique creating 4 strands for the repair. The medial most of the medial suture was passed through the medial tunnel, while the lateral passed through the central tunnel. The medial most of the lateral suture was passed through the central tunnel on the lateral passed through the lateral tunnel. A split was made in the quadriceps tendon to capture the suture. Care was taken to ensure that the not to reconstruct the extensor with sit on the superior pole of the patella on bone under the quadriceps tendon. A reduction maneuver was performed anatomically reducing the inferior pole of patella fracture and reconstructing the extensor mechanism. While holding the reduction, the suture pairs were tied into place and tensioned anatomically reconstructing the extensor mechanism. We checked our reduction radiographically and visually and found anatomic reconstruction of the patella and extensor mechanism. The medial retinaculum was then repaired with a combination of interrupted 0 Vicryl suture and a running 0 Vicryl suture. The lateral retinaculum was then repaired with the combination of interrupted 0 Vicryl suture and running 0 Vicryl suture. Subcutaneous tissues closed with 2-0 Vicryl suture. Skin was closed with Monocryl. The knee was gently flexed and Prineo applied. The incision was dressed with an OpSite visible dressing. The extremity was then placed back in the hinged knee brace locked in extension.