Wiki patella repair

[scooter1]

I really need help on this......
Patient had a knee replacement years ago. He fell.
The surgeon repaired a ruptured patella tendon ( 27380). States there were multiple bony fragments from the superior and inferior patella. These were removed. The fx was opened & the patella component was completely loose. He removed the polyethylene patella component. Freshened up the edges and then ran fiberwire distally and proximally; 2 sutures were run distally and 2 sutures proximally across the repair site. It was repaired in full extension. There were small remanants of bone in the superior patellar and they were left in place. The medial and lateral retinacular tears were repaired with 0 vicryl figure-of-eight sutures. Subcutaneous tissues were closed, etc.
He was stating he thinks I should code 27524 for ORIF of patellar fx. I also think he should
code for the repair of patellar tendon. Please, please need some input. I am only one here, so I have one to consult with.
Thank you

 

[nyyankees]

I really need help on this......
Patient had a knee replacement years ago. He fell.
The surgeon repaired a ruptured patella tendon ( 27380). States there were multiple bony fragments from the superior and inferior patella. These were removed. The fx was opened & the patella component was completely loose. He removed the polyethylene patella component. Freshened up the edges and then ran fiberwire distally and proximally; 2 sutures were run distally and 2 sutures proximally across the repair site. It was repaired in full extension. There were small remanants of bone in the superior patellar and they were left in place. The medial and lateral retinacular tears were repaired with 0 vicryl figure-of-eight sutures. Subcutaneous tissues were closed, etc.
He was stating he thinks I should code 27524 for ORIF of patellar fx. I also think he should
code for the repair of patellar tendon. Please, please need some input. I am only one here, so I have one to consult with.
Thank you

did he replace the poly liner? Yes if the tendon repair was done OUTSIDE of the ORIF you could capture. 27380 bundles as per NCCI but AAOS CodeX does not bundle. I guess NCCI assumes you would need to repair patellar tendon as part of ORIF. So again I would say if you could show in your notes that tendon repair was a separate issue I would bill it out.