How To Use CPT Code 27415

CPT 27415 describes a surgical procedure that involves the use of an open approach to repair an osteochondral defect in the knee joint using an allograft. 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 27415?

CPT 27415 can be used to describe a surgical procedure in which a provider uses an open approach to directly access the knee joint and repair an osteochondral defect. This code is specifically for procedures that require an open incision, and it should not be used for arthroscopic procedures.

2. Official Description

The official description of CPT code 27415 is: ‘Osteochondral allograft, knee, open.’

3. Procedure

1. When performing CPT 27415, the provider begins by applying a tourniquet to the patient’s leg and making an incision into the knee joint.
2. Once the osteochondral defect is visualized, the provider debrides, measures, and marks the lesion.
3. To prepare the site for graft implant, the provider may use a dowel or other methods based on the shape of the lesion.
4. The provider then carefully prepares the allograft to match the shape of the defect and places it in the appropriate position.
5. The allograft is fixed in place, and the provider tests the range of motion to ensure proper placement.
6. Finally, the provider closes the operative wound.

4. Qualifying circumstances

CPT 27415 is used for patients who have an osteochondral defect in the knee joint that requires repair. The procedure involves the use of an allograft, which is a graft taken from a person other than the recipient patient, typically from a tissue bank.

5. When to use CPT code 27415

CPT code 27415 should be used when a provider performs an open surgical procedure to repair an osteochondral defect in the knee joint using an allograft. It should not be used for arthroscopic procedures, which have a separate CPT code (29867).

6. Documentation requirements

To support a claim for CPT 27415, the provider must document the following information:

• Patient’s diagnosis and the need for osteochondral defect repair
• Details of the surgical procedure, including the use of an allograft
• Date of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the provider

7. Billing guidelines

When billing for CPT 27415, ensure that the procedure was performed using an open approach and involved the use of an allograft. It should not be reported in conjunction with CPT code 27416. If the provider repairs multiple lesions, append modifier 22 to reflect the increased complexity. Contact the payer to determine its specific guidelines for reporting CPT 27415.

8. Historical information

CPT 27415 was added to the Current Procedural Terminology system on January 1, 2005. There have been no updates to the code since its addition.

9. Examples

1. A provider performs an open surgical procedure to repair an osteochondral defect in the knee joint using an allograft.
2. A patient with a significant osteochondral defect undergoes a surgical procedure in which an allograft is used to repair the knee joint.
3. A provider uses an open approach to directly access the knee joint and repair an osteochondral defect using an allograft.
4. An individual with a damaged cartilage and bone in the knee joint undergoes a surgical procedure involving the placement of an allograft to repair the osteochondral defect.
5. A provider repairs an osteochondral defect in the knee joint using an allograft obtained from a tissue bank.
6. A patient with a knee joint injury undergoes a surgical procedure in which an allograft is used to repair the osteochondral defect.
7. A provider performs an open surgical procedure to repair an osteochondral defect in the knee joint using an allograft obtained from a tissue bank.
8. An individual with a cartilage and bone damage in the knee joint undergoes a surgical procedure involving the use of an allograft to repair the osteochondral defect.
9. A provider repairs an osteochondral defect in the knee joint using an allograft obtained from a tissue bank.
10. A patient with a knee joint injury undergoes a surgical procedure in which an allograft is used to repair the osteochondral defect.