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2025 CPT code 27412

Autologous chondrocyte implantation in the knee to repair cartilage damage.

Refer to the current CPT guidelines for detailed coding instructions.Specific guidelines may vary by payer.

Modifiers 50 (bilateral procedure), 76 (repeat procedure), and others may be applicable depending on the circumstances. Consult current CPT guidelines.

Medical necessity for ACI is typically established by demonstrating significant cartilage damage causing pain, functional limitation, and failure of conservative treatments.Specific criteria may vary by payer.

The surgeon's responsibilities include patient preparation, anesthesia, cartilage harvesting, ex vivo cell culture, arthroscopy, cartilage debridement, implantation of cultured chondrocytes, and creation and placement of a periosteal patch graft.

IMPORTANT:Do not report 27412 with 15769, 15771, 15772, 15773, 15774, 27331, 27570. For harvesting chondrocytes, use 29870.

In simple words: This surgery uses the patient's own cartilage cells to repair damaged knee cartilage. Healthy cartilage is harvested, grown in a lab, and then implanted back into the knee to fix the damage.

Autologous chondrocyte implantation (ACI) in the knee is a surgical procedure to repair damaged articular cartilage.It involves harvesting a sample of the patient's healthy cartilage, culturing it to grow more chondrocytes (cartilage cells) ex vivo, and then implanting these cultured cells into the damaged area of the knee joint. The procedure often includes arthroscopy to assess the damage and debridement of the damaged cartilage.A periosteal patch graft may be used to cover the implanted cells.

Example 1: A 35-year-old athlete with significant cartilage damage in the medial femoral condyle of the knee due to a previous injury undergoes autologous chondrocyte implantation. The procedure involves arthroscopy for assessment, debridement, and implantation of cultured chondrocytes., A 50-year-old patient with osteoarthritis experiencing significant pain and loss of function in the knee due to cartilage degeneration undergoes ACI. The procedure involves harvesting cartilage from a less-weight-bearing area of the knee, culturing the chondrocytes, and then implanting them into the damaged area after arthroscopic debridement., A 60-year-old patient with a focal cartilage defect in the patellofemoral joint undergoes ACI.The procedure is performed arthroscopically, with the cultured chondrocytes implanted into the defect, followed by the placement of a periosteal patch.

Preoperative assessment including imaging (MRI, X-ray), operative report detailing the procedure including the size and location of the lesion, amount of cartilage harvested, cell culture details (number of cells implanted), type of graft used, and postoperative care instructions. Pathology report confirming the harvested cartilage.

** This procedure is typically performed on a unilateral basis (one knee). If performed bilaterally, appropriate modifiers should be appended as per payer guidelines.The procedure may be bundled with other services depending on payer specific policies.

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