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The procedure described by CPT® Code 27409 pertains to the primary repair of torn ligaments and/or the joint capsule in the knee, specifically addressing injuries to both the collateral and cruciate ligaments. The knee joint is stabilized by four major ligaments: the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL), which are located centrally within the knee, and the medial collateral ligament (MCL) and lateral collateral ligament (LCL), which are positioned on the inner and outer aspects of the knee, respectively. The ACL and PCL are crucial for providing rotational stability, while the MCL and LCL primarily offer lateral stability. Injuries to these ligaments can result in significant instability, leading to symptoms such as buckling of the knee. The repair process involves making a skin incision over the affected area, followed by dissection of the soft tissues to access the damaged ligaments. Depending on the specific ligaments involved, the surgeon will inspect and repair the tears using sutures, and may utilize suture anchors to enhance the repair. This code is specifically designated for the primary repair of multi-ligament injuries, ensuring that the surgical intervention is accurately documented and billed. It is important to note that separate codes exist for isolated repairs of the MCL or LCL (CPT® Code 27405) and for the ACL or PCL (CPT® Code 27407), emphasizing the need for precise coding based on the ligaments involved in the injury.
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The procedure associated with CPT® Code 27409 is indicated for the repair of torn ligaments and/or the joint capsule in the knee, specifically when both collateral and cruciate ligaments are involved. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 27409 involves several critical steps to ensure effective repair of the torn ligaments and/or joint capsule. The following outlines the procedural steps:
After the completion of the surgical repair, post-procedure care is essential for optimal recovery. Patients are typically monitored for any immediate complications and may be advised to follow a rehabilitation program to regain strength and mobility in the knee. The expected recovery period can vary based on the extent of the injury and the specific ligaments repaired. Patients may need to use crutches or a knee brace during the initial healing phase to protect the repaired ligaments. Follow-up appointments are crucial to assess healing and to guide the progression of physical therapy, ensuring a return to normal activities as safely and effectively as possible.
| Short Descr | REPAIR OF KNEE LIGAMENTS | Medium Descr | RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE | Long Descr | Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments | 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 | 151 - Excision of semilunar cartilage of knee |
| 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). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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