How To Use CPT Code 27422

CPT 27422 describes a procedure used to treat a dislocating patella by reconstructing the patellar tendon insertion. 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 27422?

CPT 27422 is a code used to describe a surgical procedure that involves the reconstruction of the patellar tendon insertion to treat a dislocating patella. This procedure aims to reposition the patellar tendon, which holds the knee cap in place, to improve the stability of the knee joint. It may also involve realignment of the extensor muscles and muscle transfer or release to further enhance knee stability.

2. Official Description

The official description of CPT code 27422 is: ‘Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite type procedure).’ This code specifically refers to the surgical reconstruction of the patellar tendon insertion, along with extensor realignment and/or muscle advancement or release.

3. Procedure

1. To perform CPT 27422, the provider begins by making an incision in the skin above the patella on the inner side of the knee joint.
2. Through this incision, the provider gains access to the patellar tendon and cuts the tibial tuberosity along with the attached patellar tendon, creating a bone block.
3. The provider then moves the bone block towards the inner aspect of the tibia and secures it in place using staples or a screw.
4. Next, the provider performs extensor realignment by incising and repositioning the extensor muscles. This may involve pulling the vastus medialis muscle on the outer side of the knee and repositioning it to cross the patella, providing additional stability.
5. If necessary, the provider may also release the vastus lateralis muscle, which can help alleviate tightness and improve patellar alignment.
6. After achieving hemostasis at the surgical site, the provider closes the incision by suturing the soft tissue layers. A drain may be placed if needed.

4. Qualifying circumstances

CPT 27422 is performed on patients with a dislocating patella, a condition in which the knee cap slips out of its normal position. The procedure is intended to improve knee joint stability and alleviate pain and swelling associated with this condition. It is important to note that this procedure is typically performed by a qualified healthcare professional with expertise in orthopedic surgery.

5. When to use CPT code 27422

CPT code 27422 should be used when a provider performs a surgical reconstruction of the patellar tendon insertion, along with extensor realignment and/or muscle advancement or release. This code is appropriate for cases involving a dislocating patella that requires surgical intervention to improve knee stability. It is important to review the documentation and ensure that the procedure performed aligns with the description provided by CPT code 27422.

6. Documentation requirements

To support a claim for CPT code 27422, the provider must document the following information:

• Patient’s diagnosis of a dislocating patella
• Description of the procedure performed, including details of the patellar tendon reconstruction, extensor realignment, and any muscle advancement or release
• Date of the procedure
• Any additional procedures or interventions performed during the same surgical session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27422, it is important to ensure that the documentation supports the specific procedure performed. The provider should be qualified to perform orthopedic surgery and have the necessary expertise to perform the reconstruction of the patellar tendon insertion. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT code 27422 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a dislocating patella undergoes CPT code 27422 to reconstruct the patellar tendon insertion and perform extensor realignment to improve knee stability.
2. A provider performs CPT code 27422 on a patient with recurrent patellar dislocations, utilizing muscle advancement and release techniques to enhance patellar alignment.
3. During a surgical procedure, a provider performs CPT code 27422 to reconstruct the patellar tendon insertion and perform extensor realignment, addressing a dislocating patella and improving knee joint stability.
4. A patient with chronic patellar instability undergoes CPT code 27422, which involves the reconstruction of the patellar tendon insertion and extensor realignment to alleviate symptoms and improve knee function.
5. A provider performs CPT code 27422 on a patient with a dislocating patella, utilizing muscle advancement and release techniques to optimize patellar alignment and enhance knee stability.
6. During a surgical procedure, a provider performs CPT code 27422 to reconstruct the patellar tendon insertion and perform extensor realignment, addressing a dislocating patella and improving knee joint stability.