How To Use CPT Code 27429

CPT 27429 describes the ligamentous reconstruction (augmentation) procedure for the knee joint, involving both the intra-articular and extra-articular ligaments. 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 27429?

CPT 27429 is used to describe a surgical procedure that involves the reconstruction of both the intra-articular and extra-articular ligaments of the knee joint. This procedure may also include the use of a graft to reinforce the repair of the ligament. Intra-articular ligaments are located inside the knee joint, while extra-articular ligaments are located outside the knee joint.

2. Official Description

The official description of CPT code 27429 is: ‘Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular.’

3. Procedure

1. The surgeon begins by making an incision in the skin of the knee joint.
2. They then dissect through the soft tissue to gain access to the torn ligament.
3. The torn ends of the ligament are sutured together, and the ends are attached to the bone using screws, staples, or other fixation devices.
4. If necessary, a graft, typically taken from a patellar tendon or hamstring muscle, is used to reinforce the stability of the ligament and anchor it to the bone.
5. The surgeon then repairs the extra-articular ligaments before closing the incision.
6. Hemostasis is achieved, and the wound is closed by suturing the soft tissue layers. A drain may be placed if needed.

4. Qualifying circumstances

CPT 27429 is performed on patients who require ligamentous reconstruction (augmentation) of the knee joint. This procedure is typically indicated for patients with ligamentous injuries or instability of the knee joint. It is important to note that CPT 27429 should not be reported if primary repair of the ligament(s) is performed in conjunction with reconstruction. In such cases, the appropriate codes for primary repair should be used.

5. When to use CPT code 27429

CPT code 27429 should be used when the surgeon performs a ligamentous reconstruction (augmentation) procedure on the knee joint, involving both the intra-articular and extra-articular ligaments. This code should not be used for primary repair of the ligament(s) performed in conjunction with reconstruction.

6. Documentation requirements

To support a claim for CPT 27429, the surgeon must document the following information:

• Patient’s diagnosis necessitating the ligamentous reconstruction procedure
• Details of the procedure, including the specific ligaments reconstructed and any use of grafts
• Date of the procedure
• Any additional procedures performed in conjunction with ligamentous reconstruction
• Any complications or unexpected findings during the procedure
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 27429, ensure that the procedure performed involves both the intra-articular and extra-articular ligaments of the knee joint. It is important to note that CPT 27429 should not be reported if primary repair of the ligament(s) is performed in conjunction with reconstruction. In such cases, the appropriate codes for primary repair should be used. It is also essential to follow any specific guidelines provided by the payer regarding the use of modifiers or additional documentation requirements.

8. Historical information

CPT 27429 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 undergoes a ligamentous reconstruction (augmentation) procedure on their knee joint, involving both the intra-articular and extra-articular ligaments.
2. A professional athlete sustains a ligamentous injury to their knee joint and requires a surgical reconstruction of the ligaments.
3. A patient with chronic knee instability undergoes a ligamentous reconstruction (augmentation) procedure to improve joint stability.
4. A patient with ligamentous laxity in their knee joint undergoes a ligamentous reconstruction (augmentation) procedure to restore stability.
5. A patient with a history of ligamentous injuries in their knee joint undergoes a ligamentous reconstruction (augmentation) procedure to prevent further instability.
6. A patient with ligamentous tears in both the intra-articular and extra-articular ligaments of their knee joint undergoes a ligamentous reconstruction (augmentation) procedure to restore joint function.
7. A patient with ligamentous instability in their knee joint undergoes a ligamentous reconstruction (augmentation) procedure to improve their quality of life.
8. A patient with ligamentous injuries resulting from a traumatic event undergoes a ligamentous reconstruction (augmentation) procedure to regain knee joint stability.
9. A patient with ligamentous laxity due to a connective tissue disorder undergoes a ligamentous reconstruction (augmentation) procedure to improve joint stability.
10. A patient with ligamentous injuries in their knee joint undergoes a ligamentous reconstruction (augmentation) procedure to return to their normal activities.