How To Use CPT Code 27407

CPT 27407 describes the repair of a primary tear in the cruciate ligament or capsule of the knee. 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 27407?

CPT 27407 is used to describe the repair of a primary tear in the cruciate ligament or capsule of the knee. This procedure is performed to alleviate pain and restore gait in patients with knee injuries. It involves reattaching the torn ligament to the bone using screws and sutures, and may also involve the use of an arthroscope to view and treat defects in the joint.

2. Official Description

The official description of CPT code 27407 is: ‘Repair, primary, torn ligament and/or capsule, knee; cruciate.’ This code should be used when the provider performs a primary repair of a torn cruciate ligament or capsule in the knee.

3. Procedure

1. The provider begins by making an incision over the knee joint, after the patient is appropriately prepped and anesthetized.
2. During the procedure, the provider may use an arthroscope to view and treat defects in the joint, if necessary.
3. The torn cruciate ligament or capsule is reattached to the bone using screws and sutures.
4. The provider flushes the site with sterile saline to ensure cleanliness.
5. Hemostasis is achieved to control bleeding from incisions and suture lines.
6. The incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 27407 is used for the repair of a primary tear in the cruciate ligament or capsule of the knee. It should not be used for the repair of a tear in the collateral ligament or capsule of the knee, which is represented by a different CPT code (27405). This code is typically used for unilateral procedures, but modifiers may be appended if the provider performs the procedure on both knees.

5. When to use CPT code 27407

CPT code 27407 should be used when the provider performs a primary repair of a torn cruciate ligament or capsule in the knee. It is important to ensure that the tear being repaired is the primary tear and not a secondary tear resulting from a previous repair. If the provider is repairing a tear in the collateral ligament or capsule of the knee, a different CPT code (27405) should be used.

6. Documentation requirements

To support a claim for CPT 27407, the provider must document the following information:

• Description of the tear being repaired (cruciate ligament or capsule)
• Details of the procedure performed, including the use of an arthroscope if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Details of any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27407, ensure that the procedure performed is a primary repair of a torn cruciate ligament or capsule in the knee. This code should not be reported if a tear in the collateral ligament or capsule is being repaired. Modifiers may be appended if the procedure is performed on both knees. It is important to follow payer guidelines regarding the use of modifiers and any additional documentation requirements.

8. Historical information

CPT 27407 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a primary repair of a torn cruciate ligament in their right knee to alleviate pain and restore gait.
2. A provider performs a primary repair of a torn capsule in the left knee of a patient who experienced a knee injury.
3. A professional athlete undergoes a primary repair of a torn cruciate ligament in their knee to regain full function and return to their sport.
4. A patient with chronic knee pain undergoes a primary repair of a torn capsule in their right knee to improve their quality of life.
5. A provider performs a primary repair of a torn cruciate ligament in the knee of a patient involved in a car accident.
6. A young athlete undergoes a primary repair of a torn capsule in their knee to prevent further damage and ensure proper healing.
7. A patient with a torn cruciate ligament in their left knee undergoes a primary repair to regain stability and reduce pain.
8. A provider performs a primary repair of a torn capsule in the right knee of a patient who injured themselves while playing sports.
9. A patient with a torn cruciate ligament in their knee undergoes a primary repair to improve their mobility and overall function.
10. A provider performs a primary repair of a torn capsule in the knee of a patient who experienced a workplace injury.