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The procedure described by CPT® Code 27428 refers to ligamentous reconstruction (augmentation) of the knee, specifically performed through an intra-articular approach using an open surgical technique. The knee joint is stabilized by four major ligaments: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL). Among these, the ACL and PCL are critical for maintaining the stability of the knee during movement. The ACL is located centrally within the knee joint, connecting the femur (thigh bone) to the tibia (shin bone), while the PCL is situated behind the ACL, also connecting these two bones. Injuries to the MCL and LCL are less common and typically do not necessitate surgical intervention. When surgical reconstruction is required, it can be categorized into two types: extra-articular and intra-articular. Extra-articular reconstruction involves using structures outside the knee joint to provide additional support to the ACL and PCL, although such procedures are infrequently performed. In contrast, intra-articular reconstruction involves direct intervention within the joint capsule, allowing for a more precise repair of the damaged ligaments. The intra-articular approach for ACL reconstruction involves several critical steps, including the removal of the damaged ligament, inspection of the joint, and the use of graft material, such as the central third of the patellar tendon, to replace the ACL. This procedure is essential for restoring knee stability and function following ligament injuries, particularly in athletes and active individuals. The detailed steps of the procedure ensure that the reconstruction is performed accurately, promoting optimal recovery and rehabilitation outcomes for the patient.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 27428 is indicated for the surgical reconstruction of the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) in cases where these ligaments have been torn or damaged. The following conditions may warrant this procedure:
The intra-articular ligamentous reconstruction procedure involves several detailed steps to ensure effective repair of the damaged ligament:
After the intra-articular ligamentous reconstruction procedure, patients typically undergo a recovery period that includes monitoring for complications and managing pain. Rehabilitation is crucial and usually involves physical therapy to restore range of motion, strength, and stability to the knee. Patients are advised to follow specific post-operative care instructions, which may include rest, ice application, elevation of the leg, and gradual weight-bearing activities as tolerated. The expected recovery time can vary based on the extent of the injury and the individual’s adherence to rehabilitation protocols. Regular follow-up appointments are essential to assess healing and progress.
| Short Descr | RECONSTRUCTION KNEE | Medium Descr | LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR | Long Descr | Ligamentous reconstruction (augmentation), knee; intra-articular (open) | 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 | 152 - Arthroplasty knee |
| 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. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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). | 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) | 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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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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