jbelangue
New
What is the best cpt code for this procedure? Will you consider this a TKA or a revision due to mini subvastus approach? I'm thinking of coding this with 27486 or 27487, not sure though.
DESCRIPTION OF PROCEDURE: The patient was brought into the operating room and placed under spinal anesthetic. The left lower extremity was placed under tourniquet control, prepped and draped in a standard fashion.
An anterior incision was created from the superior pole of the patella down to the tibial tubercle. This was taken down to the extensor mechanism. A mini-subvastus approach was used. The patella was slid laterally and a 9 mm drill was used to obtain access into the distal femur and proximal tibia. A 5 degree valgus cut was created off the distal femur and this was sized to 65. The anterior, posterior chamfer cuts were created. The posterior osteophytes were removed with a half inch osteotome
Attention was placed on the proximal tibia. An intermedullary alignment rod was used to make a 90-90 cut off the superior aspect of the tibia. This was sized to a 71 component. A trial reduction showed excellent stability with a 10 poly trial.
The patella reamed down for a XS patellar component. The tibia was finished off for an I-beam component. The bony cut surfaces were pulsatile evacuated. The cement was mixed and digitally pressurized into the tibia, femur and patella. As each component was placed, excess bone cement was removed. The knee was brought into full extension with a 10 poly trial to allow the cement to cure under compression. The knee was copiously irrigated. Electrocautery was used for hemostasis. A combination of Marcaine, epinephrine and morphine was injected outside the capsule. The final 10 poly was selected, placed and locked into position. The knee was taken through a stable range of motion. The extensor mechanism was closed with #2 Ethibond at the angle and #1 barbed suture for the remainder. The skin was reapproximated with 2-0 Vicryl and closed with staples. A bulky dressing and Cryo-Cuff were applied. The patient was awakened and taken to recovery in stable condition.
DESCRIPTION OF PROCEDURE: The patient was brought into the operating room and placed under spinal anesthetic. The left lower extremity was placed under tourniquet control, prepped and draped in a standard fashion.
An anterior incision was created from the superior pole of the patella down to the tibial tubercle. This was taken down to the extensor mechanism. A mini-subvastus approach was used. The patella was slid laterally and a 9 mm drill was used to obtain access into the distal femur and proximal tibia. A 5 degree valgus cut was created off the distal femur and this was sized to 65. The anterior, posterior chamfer cuts were created. The posterior osteophytes were removed with a half inch osteotome
Attention was placed on the proximal tibia. An intermedullary alignment rod was used to make a 90-90 cut off the superior aspect of the tibia. This was sized to a 71 component. A trial reduction showed excellent stability with a 10 poly trial.
The patella reamed down for a XS patellar component. The tibia was finished off for an I-beam component. The bony cut surfaces were pulsatile evacuated. The cement was mixed and digitally pressurized into the tibia, femur and patella. As each component was placed, excess bone cement was removed. The knee was brought into full extension with a 10 poly trial to allow the cement to cure under compression. The knee was copiously irrigated. Electrocautery was used for hemostasis. A combination of Marcaine, epinephrine and morphine was injected outside the capsule. The final 10 poly was selected, placed and locked into position. The knee was taken through a stable range of motion. The extensor mechanism was closed with #2 Ethibond at the angle and #1 barbed suture for the remainder. The skin was reapproximated with 2-0 Vicryl and closed with staples. A bulky dressing and Cryo-Cuff were applied. The patient was awakened and taken to recovery in stable condition.