Knee Ligament Repair vs Reconstruction

Question:

What type of graft or fixation material is required to report open extra-articular knee ligament reconstruction code 27427? Our physician is listing “MCL repair” and “MCL reconstruction” within the same operative note. It first describes repair of the ligament using Suture Tape. In a separate paragraph the physician describes insertion of additional Tape, but calls the work “reconstruction”.

Answer:

Reconstruction CPT codes are used when biologic tissue is used to replace insufficient, nonfunctioning, or missing native tissue. The replacement biologic tissue may be an autograft (harvested from the patient) or an allograft (harvested from a cadaver). In this example the physician is using additional Suture Tape to supplement or protect the repair; that is not considered reconstruction.