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The procedure described by CPT® Code 27380 involves the surgical suture of the infrapatellar tendon, which is more accurately classified as a ligament connecting the tibia (shinbone) and the patella (kneecap). This tendon plays a crucial role in the stability and function of the knee joint. The surgical approach begins with a midline incision that extends from the top of the patella down to the medial aspect of the tibial tubercle, allowing for adequate exposure of the area. During the procedure, medial and lateral flaps are created to facilitate exploration of the surrounding structures, specifically the medial and lateral retinacula, which are connective tissues that support the knee. Once the surgical site is adequately exposed, the torn infrapatellar tendon is identified and mobilized for repair. Debridement, which involves the removal of damaged tissue, is performed on the torn tendon, and depending on the location of the tear, additional debridement may be necessary on the tibial tubercle and/or the inferior pole of the patella. The next step involves placing sutures in the torn tendon, followed by preparing the bony surfaces of the tibial tubercle and/or inferior pole of the patella. This preparation may include drilling tunnels or placing suture anchors to facilitate the secure attachment of the tendon to the bone. The sutures from the tendon are then passed through these tunnels or anchors, effectively securing the infrapatellar tendon to the bone. In some cases, a second drill hole may be created in the tibial tubercle, allowing for a suture to be passed from the tibial tubercle through the quadriceps tendon at the upper pole of the patella. This step is critical for evaluating and ensuring the correct patellar height, which is essential for optimal knee function. Once the appropriate height is confirmed, the sutures of the infrapatellar tendon are tied off to secure the repair. The procedure concludes with irrigation of the wound and closure of the incision, ensuring a clean and secure surgical site. For cases requiring a secondary suture repair of the infrapatellar tendon, including the use of fascial or tendon grafts, CPT® Code 27381 should be utilized, which involves a different surgical approach to address the defect.
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The procedure described by CPT® Code 27380 is indicated for the repair of a torn infrapatellar tendon, which may occur due to acute injury or chronic degeneration. The following conditions may warrant this surgical intervention:
The surgical procedure for CPT® Code 27380 involves several critical steps to ensure effective repair of the infrapatellar tendon:
After the completion of the procedure, post-operative care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or excessive swelling. Rehabilitation may include physical therapy to restore strength and range of motion in the knee. Patients are advised to follow specific weight-bearing restrictions and activity modifications as directed by their healthcare provider to ensure proper healing. Follow-up appointments are necessary to assess the healing process and to make any adjustments to the rehabilitation plan as needed.
| Short Descr | REPAIR OF KNEECAP TENDON | Medium Descr | SUTURE INFRAPATELLAR TENDON PRIMARY | Long Descr | Suture of infrapatellar tendon; primary | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | ET | Emergency services | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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