There are two sets of ligaments that stabilize
the knee joint. The medial and lateral collateral ligaments are known
as extra-articular ligaments because they are located outside the
joint. The anterior and posterior cruciate ligaments are located
within the joint so they are termed inta-articular ligaments. In
instances when a patient sustains a serious knee injury it may be
necessary to reconstruct both the ACL and PCL. The CPT code for this
procedure reads “Ligamentous reconstruction (augmentation),
knee; intra-articular (open) – since there is no mention of
one or more ligaments how should this code be reported?
A recent article in CPT Assistant instructs coders to report CPT
code 27428 for reconstruction of the ACL and 27428-59 for reconstruction
of the PCL, so it would be appropriate to report this code one time
for each ligament that is reconstructed.
All information contained in The Coding Advocate is intended to comply with NCCI coding edits. Certain issues can vary by state and carrier. In the event you believe anything published by mdStrategies is not valid, please use the Contact Us tab to discuss your situation. Also, make note of the date on any older issues.