Wiki Total Knee Arthroplasty and Patellar Tendon Repair

[TnRushFan]

Our patient had previous ACL repair.
My surgeon documented removal of instrumentation, total knee arthroplasty and patellar tendon repair. My surgeon is wanting to bill for all procedures...I finally convinced him we cannot code the screw removal as it accommodated the arthroplasty but he is still adamant about coding the patellar tendon repair at same time of total knee arthroplasty. Our coding software does not bundle them but I am hesitant to code them together.
Any insights will be greatly appreciated.

 

[amyjph]

I think I would have to see the op note and the diagnoses documented. What was the reason for the repair, was it ruptured prior to the TKA? Complete, partial, tendonitis? Was it somehow injured or cut during the course of the TKA? Was there a graft at all?
I would be hesitant to code it as well since AAOS GSD states release, repair, advancement, or reconstruction of ligament or capsule (eg, 27405, 27407, 27425, 27435) are included. Even though this doesn't show 27380 or 27381 it seems iffy.

Did you check CPT Assistant?

I can't remember ever seeing this done during a TKA of the hundreds I have coded. Usually you see it after when they have a major complication and extensor mechanism rupture or patellar tendon rupture after the TKA at some point.

Agree, you can't code the screw removal.