How To Use CPT Code 27405

CPT 27405 describes the primary repair of a torn collateral ligament and/or capsule in the knee joint. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27405?

CPT 27405 is used to describe the primary repair of a torn collateral ligament and/or capsule in the knee joint. This code is used when the provider immediately repairs the torn ligament or capsule after the injury. Collateral ligaments are the ligaments located on the inner or outer side of the knee joint.

2. Official Description

The official description of CPT code 27405 is the “Repair, primary, torn ligament and/or capsule, knee; collateral.” This code is used when the provider performs the primary repair of a torn collateral ligament and/or capsule in the knee joint.

3. Procedure

1. The provider begins by making an incision in the skin on the inner or outer side of the knee, depending on the location of the torn capsule or ligament.
2. They then dissect through the soft tissue to gain access to the torn ligament or capsule.
3. The torn ligament or capsule is repaired by suturing the torn part or fixing the torn portion back in place using a screw or K-wire.
4. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.
5. If necessary, a drain may be placed.

4. Qualifying circumstances

CPT 27405 is performed when there is a torn collateral ligament and/or capsule in the knee joint that requires primary repair. This procedure is typically performed immediately after the injury. The provider must assess the patient’s condition and determine the need for primary repair of the torn ligament or capsule.

5. When to use CPT code 27405

CPT code 27405 should be used when the provider performs the primary repair of a torn collateral ligament and/or capsule in the knee joint. This code is appropriate when the repair is done immediately after the injury. It should not be used for revision or reconstruction procedures.

6. Documentation requirements

To support a claim for CPT 27405, the provider must document the following information:

• Patient’s diagnosis indicating the torn collateral ligament and/or capsule
• Details of the procedure, including the incision site and the repair technique used
• Date of the procedure
• Any additional procedures performed, such as drain placement
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27405, ensure that the procedure performed is the primary repair of a torn collateral ligament and/or capsule in the knee joint. This code should not be reported with other codes for revision or reconstruction procedures. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 27405 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to this code since its addition.

9. Examples

1. A patient sustains a torn collateral ligament in their knee during a sports injury. The provider performs the primary repair of the torn ligament immediately after the injury.
2. After a fall, a patient presents with a torn capsule in their knee joint. The provider performs the primary repair of the torn capsule during the same visit.
3. A car accident results in a torn collateral ligament in the patient’s knee. The provider performs the primary repair of the torn ligament to restore stability to the joint.
4. A patient with a torn capsule in their knee joint undergoes primary repair to promote healing and prevent further damage.
5. During a routine examination, the provider discovers a torn collateral ligament in the patient’s knee. The primary repair is performed to restore normal function and prevent instability.